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目的:观察结石封堵器在输尿管上段结石治疗中的临床效果及安全性。方法:回顾分析2010年11月~2015年8月期间应用国产输尿管封堵器治疗输尿管上段结石患者50例的临床资料,其中男34例,女16例。所有患者结石均位于第4腰椎横突以上,结石长径为0.7~2.8cm,平均1.4cm;结石病史3周~28个月,合并有不同程度肾积水。均采用国产输尿管封堵器下行钬激光碎石术,具体方法为应用Storz或Olympus F9.8输尿管硬镜,在其下方侧孔放置结石封堵器通过结石位置,另一孔置入钬激光光纤碎石。结果:除1例0.7cm结石位置较高滑入肾盂内,采用改变体位后结石重新滑回肾盂出口处碎石成功外,其他均一次性放置结石封堵器成功碎石。所有患者术中无输尿管穿孔、假道等并发症发生,术后无发热和低血压等并发症。所有患者术后复查KUB无结石残留,随访2~3个月复查发现结石清除效果好,肾盂肾盏内无残留结石,患侧肾积水消退或减轻。结论:应用输尿管结石封堵器能显著提高输尿管上段结石碎石成功率,减少手术并发症和预防术后不良反应发生,值得临床应用和推广。
Objective: To observe the clinical effect and safety of stone occluder in the treatment of upper ureteral calculi. Methods: Clinical data of 50 patients with upper ureteral calculi treated with domestic ureteral occluder during November 2010 to August 2015 were retrospectively analyzed, including 34 males and 16 females. All patients with stone are located in the 4th lumbar transverse process, the long diameter of 0.7 ~ 2.8cm, an average of 1.4cm; stone history of 3 weeks to 28 months, with varying degrees of hydronephrosis. Are made of domestic ureter occluder Holmium laser lithotripsy, the specific method for the use of Storz or Olympus F9.8 ureteroscope, placed in the side hole below the stone occluder through the stone position, the other hole into the holmium laser fiber gravel. Results: In addition to a 0.7cm stone position higher slide into the renal pelvis, with the position of the stone to slide back to the pelvis outlet again gravel success, the other were placed stone lithotripsy success gravel. All patients had no perforation of ureter and no complications during the operation, such as fever and hypotension. All patients were reviewed after KUB stones without residual, follow-up of 2 to 3 months found that stone removal effect is good, no residual calyceal calculus, ipsilateral hydronephrosis subsided or reduced. Conclusion: The application of ureteral calculi occluder can significantly improve the success rate of lithiasis in the upper ureter, reduce the complications and prevent postoperative adverse reactions, which is worthy of clinical application and promotion.