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目的探讨腔内钬激光碎石术治疗上段输尿管结石的技巧与方法。方法回顾性分析121例应用硬性输尿管肾镜和钬激光碎石术治疗上段输尿管结石患者资料。结果单次碎石成功率为95%(115/121)。术后随访2周~6个月,除6例失败者外,结石排净率98%(113/115),I VU示肾盂积水由术前(3.5±0.8)cm降至(1.5±0.4)cm(P<0.01),无输尿管狭窄发生。结论腔内钬激光碎石术治疗上段输尿管结石,尤其是结石直径>1cm同时合并输尿管息肉及狭窄者有明显优势,熟练掌握输尿管镜的技巧和方法是保证手术成功的重要因素之一。
Objective To explore the techniques and methods of treatment of upper ureteral calculi with holmium laser lithotripsy. Methods The clinical data of 121 patients with ureteral calculi treated with rigid ureteroscope and holmium laser lithotripsy were retrospectively analyzed. Results The success rate of single gravel was 95% (115/121). The patients were followed up for 2 weeks to 6 months. Except 6 patients, the stone removal rate was 98% (113/115). The I VU showed that the hydronephrosis decreased from 3.5 ± 0.8 cm to 1.5 ± 0.4 ) cm (P <0.01), no ureteral stricture occurred. Conclusion Holmium laser lithotripsy for the treatment of upper ureteral calculi, in particular, the diameter of stone> 1cm combined with ureteral polyps and stenosis have obvious advantages, skillful ureteroscopy techniques and methods to ensure the success of surgery is one of the important factors.