输尿管软镜钬激光碎石术治疗上尿路结石的体会

Experience of flexible ureteroscopy combined with holmium laser lithotripsy for renal and upper ureter calculi

摘要:

目的 总结输尿管软镜钬激光治疗输尿管上段结石及肾结石的疗效及并发症的预防，探讨影响结石清除率的因素。方法 65例上尿路结石患者接受输尿管软镜钬激光碎石治疗，先使用8/9.8F输尿管硬镜探查患侧输尿管，置入导丝后留置输尿管软镜鞘，引入输尿管软镜，钬激光碎石。结果 50例患者一期顺利碎石。手术时间40～190 min，平均115 min。术后14例患者发热，无其他严重并发症。术后1～3个月拔除内支架，结石总清除率为92.3%。结论 输尿管软镜结合钬激光是上尿路结石的有效手段，结石大小、结石位置及积水轻重是影响结石清除率的主要因素。

Abstract:

Objective To sum up the therapeutic effect and complications of the treatment of ureteral calculi with holmium laser in the treatment of renal and upper ureter calculi. To explore the factors that affect the removal rate of stones. Methods 65 cases of renal and upper ureter calculi received flexible ureteroscopy combined with holmium laser lithotripsy. Result 50 cases of patients with a smooth gravel. Operation time 40～190min, average 115min. 14 cases had fever, no other serious complications occurred. After 1～3 months, remove the stent. Total stone clearance rate was 92.3%. Conclusion Flexible ureteroscopy (FURS) is an effective method for renal and upper ureter calculi. The stone size, location and degree of water are the main factors affecting the removal rate.