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目的:探讨输尿管镜钬激光联合封堵器治疗输尿管结石的临床疗效。方法:回顾性分析2013年6月~2016年3月经输尿管镜钬激光碎石术中联合应用封堵器及异物钳治疗82例输尿管结石患者资料,其中下段输尿管30例,中段输尿管结石23例,上段输尿管结石29例。统计患者手术时间、结石清除率、术后并发症等数据进行分析。结果:手术时间下段(5.0~14.5)min,中段(5.5~32.5)min,上段(7.5~43.0)min。术后3d行KUB平片检查,下段无结石残留,结石取净率为100%;中段1例结石残留,结石取净率为95.65%;上段有1例结石入肾盂,1例结石残留,结石取净率为93.10%。术中均未出现输尿管穿孔或输尿管黏膜撕脱。术后5例出现高热,经抗感染对症治疗好转。术后7例肉眼血尿,经膀胱冲洗治疗后好转。结论:封堵器结合异物钳应用于输尿管镜下钬激光碎石治疗输尿管全段结石,能显著提高结石清除率,减少输尿管镜碎石术中结石移位,缩短住院时间,安全有效,成功率高,是治疗输尿管全段结石的一种重要手段。
Objective: To investigate the clinical efficacy of ureteroscopic holmium laser occlusion device in the treatment of ureteral calculi. Methods: The data of 82 cases of ureteral calculi treated by ureteroscopic holmium laser lithotripsy combined with occluder and foreign body forceps were analyzed retrospectively from June 2013 to March 2016. Among them, 30 cases of ureter, 23 cases of middle ureteral calculi, Upper ureteral calculi in 29 cases. Statistics of patients with surgery time, stone clearance rate, postoperative complications such as data analysis. Results: In the lower segment of operation time (5.0-14.5) min, middle segment (5.5-32.5) min and upper segment (7.5-43.0) min. Postoperative KUB plain film examination on the 3rd line, no stones in the lower part of the residue, the stone to take the net rate was 100%; the middle one case of stone remains, the stone removal rate was 95.65%; the upper section of the stone into the renal pelvis, 1 case of residual stones, stones Take the net rate of 93.10%. Ureteral perforation or ureteral mucosal avulsion did not occur during surgery. After 5 cases of high fever, anti-infective symptomatic treatment improved. Seven cases of gross hematuria after treatment of bladder irrigation improved. Conclusion: The occluder combined with foreign body forceps in the ureteroscopic holmium laser lithotripsy for the treatment of ureteral calculi, can significantly improve the stone clearance rate, reduce ureteral lithotripsy stones shift, shorten the hospital stay, safe and effective, the success rate High, is an important means of treatment of ureteral calculi.