【摘要】 目的探讨钬激光碎石治疗输尿管结石的有效性和安全性。方法应用半硬性输尿管肾镜和钬激光碎石治疗238例输尿管结石,其中输尿管上段结石60例,中段93例,下段85例。结果单次碎石成功率97.1%(231/238),其中上段结石单次碎石成功率91.7%(55/60),中、下段为98.9%(176/178)。5例双侧输尿管结石合并急性肾功能衰竭、无尿恢复迅速。术中无输尿管穿孔及严重损伤等并发症发生。231例术后住院1～2d,平均1.3d。术后随访0.5～12个月,平均4.1月,结石排净率98.7%(228/231),无输尿管狭窄发生。结论钬激光碎石术治疗输尿管结石疗效好、创伤轻微、安全,是输尿管结石特别是中、下段结石首选的治疗方法。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of holmium laser lithotripsy for ureteral stones. Methods A total of 238 patients with ureteral stones (upper segment, 60 patients; middle segment, 93; lower segment, 85) received the holmium laser lithotripsy under a semi-rigid ureteropyeloscope. Results Stones were successfully fragmented on one session in 97.1% of patients (231/238). The success rate was 91.7% in patients with stones in the upper ureteral segment (55/60) and 98.9% in patients with stones in the!mid-lower ureteral segment (176/178). Five patients with bilateral ureteral stones associated with acute renal failure and anuria returned to normal rapidly. No complications such as perforation or severe trauma were encountered during the operation. The postoperative hospital stay of the 231 patients was 1~2 days (mean, 1.3 days). Follow-up for 0.5~12 months (mean, 4.1 months) revealed a stone-free rate of 98.7% (228/231). No stricture of the ureter was found. Conclusions Holmium: YAG laser lithotripsy is effective, mini-invasive and safe. It is indicated as the first choice in the treatment of ureteral stones, especially stones located in the mid-lower ureteral segment.更多还原