Objective To evaluate the effectiveness and safety of Holmium laser and flexible ureteroscope combined with rigid ureteroscope in the endoscopic treatment for complicated upper ureteral calculi. Methods Various clinical parameters were analyzed retrospectively in 37 patients with complicated upper ureteral calculi from January 2008 to August 2014, 22 were male and 15 were female. the average age of all patients was 40. 3. Of all the stones found, 19 were on the right side and 18 were on the left, and 3 patients had bilateral ureteral calculi. There were different degrees of the hydronephrosis in all the 37 cases. A-mong which,11 cases had urteral stricture or distortion, 30 cases had polypus, and 9 cases were fail of ESWL. Results 89. 2%(33/37) patients obtained satisfactory lithotripsy effect with one operation. Nevertheless, 2 patients changed to adopt open opera-tion due to ureteral perforation and distortion. 2 patients underwent two-stage operation due to the failure of puting ureteroscope. Conclusion Holmium laser and flexible ureteroscope combined with rigid ureteroscope is a safe and effective treatment for the complicated upper ureteral calculi.%目的 探讨输尿管软镜联合输尿管硬镜钬激光腔内治疗复杂性输尿管上段结石的有效性及安全性. 方法回顾性分析2008年1月至2014年8月收治的经输尿管软镜联合输尿管硬镜钬激光治疗复杂性输尿管上段结石37例患者的临床资料. 其中男22例,女15例;平均年龄40. 3岁;结石位于右侧19例,左侧18例,双侧输尿管结石3例;37例均伴有患侧轻～中度肾盂积水,其中11例合并结石远端输尿管扭曲或狭窄,30例合并有息肉或肉芽组织包裹,9例为ES-WL治疗失败患者. 结果 37例中33例单次手术碎石成功,单次手术结石粉碎率达89. 2%( 33/37 ). 1例进镜时输尿管穿孔;1例因输尿管严重扭曲改为开放手术;2例软镜不能直接到达结石处,留置 F6 双J管,1周后再行输尿管软镜碎石.结论 输尿管软镜联合输尿管硬镜钬激光碎石术治疗复杂性输尿管上段结石安全、有效,是一种疗效确切的腔内泌尿外科碎石方法.
展开▼
