经输尿管镜钬激光治疗输尿管上段结石的临床分析

目的：探讨经输尿管镜钬激光治疗输尿管上段结石的临床疗效。方法选择我院2011年1月至2013年3月收治的462例输尿管结石患者，其中92例输尿管上段结石，结石大小约0.5～1.8cm，均行经输尿管镜钬激光碎石术，钬激光能量为（0.6～1.5J/10～15HZ）。结果92例输尿管上段结石患者中76例一次碎石成功，治疗成功率为82.6％，手术时间20～110分钟，平均42.0分钟，术后住院时间平均3.2天。无输尿管黏膜穿孔，撕脱等并发症。术后当天出现畏寒、高热者3例，给予静脉抗感染和对症治疗后均恢复。术后2个月共86例结石获完全清除，结石清除率93.5％。结论经输尿管镜钬激光治疗输尿管上段结石安全、高效、创伤小、并发症少、成功率高、住院时间短等优点，是目前输尿管结石的最理想治疗方法，术后补救性体外冲击波碎石治疗可以提高清石率。

Clinical analysis of holmium laser by ureteroscope for treating upper ureteral calculi

Objective To discuss the clinical effects of holmium laser by ureteroscope for treating upper ureteral calcu -li.Methods 462 patients with ureteral calculi in our hospital form Jan.,2011 to Mar.,2013 were selected,in which 92 cases had upper ureteral calculi with the size of 0.5~1.8 cm and were performed holmium laser lithotripsy by ureteroscope.The holmium laser energy was 0.6~1.5J/10~15HZ.Results 76 out of 92 patients had only one lithotripsy ,and the successful rate was 82.6%.The operation time was 20~110 min,42.0 min on average ,and the postoperative hospital stays was 3.2 days on average.There were no complications like ureteral mucosal perforation and avulsion.Three patients suffered from aversion to cold and high fever on the day after operation ,and recovered after venous anti -infection and corresponding treatment.2 months after operation ,the ureteral calculi of 86 patients were completely removed ,and the stone clearance rate was 93.5%.Conclusion Holmium laser by ureteroscope in the treatment of upper ureteral calculi is an ideal method at present ,with advantages of safety ,high efficacy,minimal invasion,less complications and quick rehabilitation.Remedial extracorporeal shock wave lithotripsy after operation can improve the stone clearance rate.