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目的观察输尿管镜钬激光碎石术治疗输尿管结石的疗效。方法对900例输尿管结石患者(输尿管上段结石260例、中下段640例,结石0.6 cm×0.4×0.5 cm～2.2 cm×1.2 cm×0.8 cm大)行输尿管镜下钬激光碎石术治疗。结果 260例输尿管上段结石患者中,原位单次碎石成功220例(86.2%);640例输尿管中下段结石患者中,单次碎石成功624例(97.5%)。40例结石回漂至肾盏内,留置双J管后改行体外冲击波碎石(ESWL),碎石成功。平均手术时间为34 min。无输尿管黏膜严重穿孔、撕脱等并发症发生,术后平均住院时间3.1 d。术后平均随访3个月,结石排净率为98%(882/900)。结论输尿管镜钬激光碎石术治疗输尿管结石疗效好、安全,可作为治疗输尿管结石,尤其是输尿管中下段结石的首选方法。
Objective To observe the efficacy of ureteroscopic holmium laser lithotripsy in the treatment of ureteral calculi. Methods A total of 900 patients with ureteral calculi underwent ureteroscopic holmium laser lithotripsy (260 cases of upper ureteral calculi, 640 cases of middle and lower segments, and stones of 0.6 cm × 0.4 × 0.5 cm ~ 2.2 cm × 1.2 cm × 0.8 cm). Results Among the 260 patients with upper ureteral calculi, 220 cases (86.2%) were successfully treated with single gravel in situ and 624 cases (97.5%) were successful with single gravel in 640 patients with middle and lower ureteral calculi. 40 cases of stone back to the calyce calculus, leaving double J tube after the conversion of extracorporeal shock wave lithotripsy (ESWL), gravel success. The average operation time was 34 min. No ureteral mucosa serious perforation, avulsion and other complications occurred, the average postoperative hospital stay 3.1 d. After an average follow-up of 3 months, the stone clearance rate was 98% (882/900). Conclusion Ureteroscopic holmium laser lithotripsy for the treatment of ureteral calculi is effective and safe, and can be used as the preferred method for the treatment of ureteral calculi, especially in the lower ureter.