【摘要】 目的分析输尿管镜下钬激光碎石术改开放手术原因,如何准确把握开放手术时机。有效控制输尿管镜手术并发症的发生率。方法回顾分析187例197侧输尿管结石行输尿管镜下钬激光碎石术的资料。男112例,女75例,年龄17～80岁,左输尿管结石85例,右输尿管结石92例,双侧输尿管结石10例。结果8例输尿管镜下钬激光碎石术中转开放(4.06%),其中2例寻找输尿管开口失败,4例系输尿管狭窄,扭曲上镜困难,另2例系碎石术中损伤致输尿管断裂。结论输尿管硬镜下钬激光碎石术因输尿管病变、损伤等原因可能导致严重并发症。提高操作技巧,准确掌握开放手术时机对有效降低其手术并发症具有重要意义。更多还原

【Abstract】 Objective To analyse the cause for turning ureteroscopy with holmium laser lithotripsy into open surgery,how to seize exactly the opportunity of open surgey and avoid effectively the complication of it.Methods The clinical data of 187 cases (197 sites of 112 males and 75 females) of ureteroscopy with holmium laser lithotripsy were reviewed retrospectively.Their age ranged from 17-80 years old.In these patients left ureteral calculi were 85 cases,right 92,and double 10.Results Eight cases of the ureteroscopy with holmium laser lithotripsy were turned open surgery (4.06%),2 of the ureteral orifice could not be seeked.4 of ureters were too narrow to be propelled up for the ureteroscopy.and another 2 of ureters were broken by instrument and fibre trauma to it during stone fragmentation.Conclusions It perhaps results in serious relative complication for ureteroscopy with holmium laser lithotripsy by ureteric trauma.The key point to avoid effectively the complication is to increase the surgical skill and study carefully the clinical data before operation,perfect surgical skill and to seize the opportunity of turning ureteroscopy with holmium laser lithotripsy into open surgery.更多还原