输尿管镜下钬激光碎石治疗输尿管结石134例临床报告

摘要

目的 探讨经尿道输尿管镜下钬激光碎石术治疗输尿管结石的可行性、有效性和安全性.方法 回顾性分析2013年6月至2016年3月在本院行输尿管镜下钬激光碎石治疗134例患者的临床资料,观察患者的碎石率、排石率以及并发症等情况.结果 134例患者一次碎石成功,碎石成功率94.03%(126/134);其中,上段结石碎石成功率为85.71%(36/42),中、下段结石碎石成功率为98.30%(90/92);手术时间30~100分钟,平均55分钟,术后住院时间3~9天.术后无出血、输尿管穿孔等并发症,4例老年女性患者术后出现感染性休克.结论 输尿管镜下钬激光碎石治疗输尿管结石可靠、高效、安全,尤其对于中、下段输尿管结石效果更佳.%Objective To investigate the feasibility、effects and safety of holmium laser lithotripsy under ureteroscopy for ureteral calculi.Methods Clinical data of 134 patients with ureteral calculi treated by holmium laser lithotripsy under ureteroscopy in our hospital from March 2013 to March 2016 were reviewed retrospectively.The success rate of rubble, stone clearance rate and complications rate were observed.Results The overall rate of successful fragmentation for all levels of ureteral calculi in a single procedure achieved 94.03% (126/134).The success rates of fragmentation for upper and mid-lower segment of ureteral calculi was 85.71% (36/42) and 98.30% (90/92).The mean operative time was 55 minutes (30~100 minutes) and hospital stay ranged from 3 to 9 days.There was no bleeding, ureteral perforation and other complications after ureteroscopy.However, septic shock was occurred in 4 cases of elderly women.Conclusions Holmium laser lithotripsy under ureteroscopy is feasible, high effective and safe for the treatment of ureteral calculi, especially for the middle and lower level ureteral calculi.