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目的:探讨改良输尿管镜钬激光碎石术治疗输尿管结石的手术技巧及临床疗效。方法:回顾性分析我院于2011年9月～2012年10月行改良输尿管镜钬激光碎石术治疗输尿管结石的76例患者的临床资料,观察采用F3输尿管导管引导碎石并冲洗术野,术前配合速尿静推,运用结石封堵器等手术技巧的临床疗效。结果:本组76例患者一次性碎石成功率94.7%(72/76);上段结石碎石成功率91.3%(21/23),中下段结石碎石成功率95.6%(43/45),膀胱壁内段结石碎石成功率100%(8/8);手术时间21～83min,平均33min,术后住院时间2～9d,平均3.9d。结论:改良输尿管镜钬激光碎石术是治疗输尿管结石安全、有效的手术方法,熟练掌握进镜技巧并采用F3输尿管导管引导冲洗术区,术前速尿的使用以及结石封堵器等应用,可以有效的提高碎石成功率,缩短手术时间及术后住院时间,并减少术中术后并发症。
Objective: To explore the surgical techniques and clinical efficacy of modified ureteroscopic holmium laser lithotripsy in the treatment of ureteral calculi. Methods: The clinical data of 76 patients with ureteral calculi treated by modified ureteroscopic holmium laser lithotripsy in our hospital from September 2011 to October 2012 were retrospectively analyzed. The F3 ureteral catheter was used to guide the lithotripsy and to wash the operative field. Preoperative with furosemide push, the use of stone occluder surgical techniques such as clinical efficacy. Results: The success rate of one-off grafting in this group was 94.7% (72/76). The success rate of upper grading stone was 91.3% (21/23), middle grading stone grading success rate was 95.6% (43/45) The success rate of stones in the bladder wall was 100% (8/8). The operation time ranged from 21 to 83 minutes with an average of 33 minutes. The postoperative hospital stay was from 2 to 9 days with an average of 3.9 days. Conclusions: Modified ureteroscopic holmium laser lithotripsy is a safe and effective surgical treatment of ureteral calculi, proficiency in the mirror technique and the use of F3 ureteral catheter to guide the irrigation area, the use of preoperative furosemide and stone occluder applications, Can effectively improve the success rate of gravel, shorten the operation time and postoperative hospital stay, and reduce intraoperative and postoperative complications.