Objective To study the value of Ntrap stone extraction in the treatment of upper ureteral stones with holmium laser lithotripter under a ureteroscope. Methods A total of 45 patients with upper urelera] stones, who were treated with Ntrap stone extraction combined with holmium laser lithotripsy by ureteroscupy in our hospital between March 2009 and May 2011, were enrolled in this study. The success rate of lithotripsy, operation time, rate of ureteral perforation, intraoperative blood loss, clearance of calculus, and improvement of hydronephrosis in 4 weeks were retrospectively analyzed. Results The procedure was completed successfully in all the cases, and in 95. 6% (43/45) of them, the stones were fragmented in one session. In 2 case, the stones were pushed upward and thus the patients received extracorporeal shock wave lithotripsy { ESWL) afterwards. None of the 45 patients had ureter perforation. The mean operation time was (45 ± 13) min, and the mean intraoperative blood loss was (8.7 ± 1.5) ml. No lithiasis fragments were observed with in one month after the surgery. The hydronephrosis was improved from preoperative (3.4 ±0.8) cm to postoperative (1.2 ±0. 3) cm, as shown by B-ultrasonography. The patients were followed up for 1 to 12 months with a mean of 6. 5 months, during which no recurrent stones were detected. Conclusion Ntrap stone extraction can effectively prevent ureteral stones from moving upward during ureteroscopic holmium laser lithotripsy. Combined with holmium laser lithotripsy, it is effective, safe and minimally invasive for upper ureteral stones.%目的 探讨NTrap结石拦截网在输尿管镜下钬激光碎石治疗输尿管上段结石中的应用价值. 方法 2009年3月～2011年5月输尿管镜下NTrap结石拦截网配合钬激光碎石系统治疗输尿管上段结石45例,对碎石成功率、手术时间、输尿管穿孔、术中出血量和肾积水情况进行分析. 结果 输尿管上段结石均被拦截网固定后碎石,一次性碎石成功率95.6％ (43/45),2例结石上移入肾脏术后结合体外冲击波碎石治愈.术中无输尿管穿孔.手术时间(45±13) min;术中出血量(8.7±1.5)ml.术后1个月B超检查均无结石残留,肾盂积水由术前(3.4±0.8)cm降至(1.2±0.3)cm.45例随访1～12个月,平均6.5月,均无结石复发. 结论 NTrap结石拦截网可有效防止输尿管镜下钬激光碎石过程中结石移位,与钬激光碎石系统联合应用治疗输尿管上段结石具有结石清除率高、安全性好、创伤小等特点.
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