【摘要】 目的探讨输尿管镜碎石术治疗输尿管结石的临床疗效与手术安全性。方法对2016—2018年在上海中医药大学附属第七人民医院行输尿管镜碎石术治疗的648例输尿管结石患者的临床资料进行回顾性分析,总结其手术方式、碎石成功率、手术时间、住院时间及并发症发生情况。结果 648例行输尿管镜碎石术治疗的输尿管结石患者,采用气压弹道106例,钬激光碎石542例;成功碎石621例,碎石成功率为95.8%;手术时间平均为45 min,住院时间平均5 d。648例患者中19例结石上移至肾脏,留置输尿管支架管后行ESWL治疗16例,二期输尿管软镜下钬激光碎石治疗3例;发生输尿管穿孔2例,黏膜损伤32例,活动性出血7例;改行开放手术治疗8例。结论微创输尿管镜碎石术治疗输尿管结石虽然会发生一定的并发症,但整个手术治疗过程比较安全,疗效也较为显著。更多还原

【Abstract】 Objective To investigate the efficacy and safety of ureteroscopic lithotripsy for ureteral calculi.Methods Clinical data of 648 patients who underwent ureteroscopic lithotripsy for ureteral stones in the Seventh Affiliated People’s Hospital of Shanghai University of Traditional Chinese Medicine between 2016-2018 were analyzed retrospectively.The surgical method,success rate,operation time,hospital stay and complications were summarized.Results Among the 648 patients,pneumatic lithotripsy was performed in 106,and holmium laser lithotripsy in 542.A total of 621 patients(95.8%) successfully completed the lithotripsy.The average operation time and hospital stay were 45 minutes and 5 days,respectively.The stones moved into the kidney in 19 patients.The extracorporeal shock wave lithotripsy(ESWL) was performed after placement of indwelling ureteral stentin 16 patients.The second-stageureteroscopicholmium laser lithotripsy was carried out in 3 patients.In addition,2 patients had ureteral perforation,32 patients had mucosal injury,7 patients had active hemorrhage,and 8 patients were converted to open surgery.Conclusion Althoughureteroscopic lithotripsy may cause complications,it has high safety and efficacy in the treatment of ureteral calculi.更多还原