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目的探讨腔内钬激光碎石治疗老年输尿管结石患者的安全性及有效性。方法回顾性分析63例老年输尿管结石腔内钬激光碎石治疗患者的资料。结果 60例手术成功,3例因进镜失败改开放取石,2例输尿管上段结石滑入肾盂于术后1周行体外冲击波碎石,输尿管上、中、下段碎石成功率分别为88.2%、96.2%和95.0%。平均手术时间47(30～75)min,术中7例出现输尿管黏膜出血,2例发生输尿管穿孔。术后9例出现较重的肉眼血尿,2例发生尿路感染。术后2个月复查KUB 1例结石残留于肾盂内,1例残留于原部位。结论腔内钬激光碎石治疗老年输尿管结石安全有效,具有创伤小、碎石效果好、并发症少等优点,是治疗老年输尿管结石的较好选择。
Objective To investigate the safety and efficacy of endoscopic holmium laser lithotripsy in the treatment of senile ureteral calculi. Methods A retrospective analysis of 63 elderly patients with ureteral calculi holmium laser lithotripsy patients. Results The operation was successful in 60 cases, 3 cases failed to open the stone due to failed to enter the mirror, 2 cases of upper ureteral calculi slid into the renal pelvis in 1 week after operation. The success rate of extracorporeal lithotripsy was 88.2% 96.2% and 95.0%. The mean operative time was 47 (30-75) minutes. Ureteral mucosal hemorrhage occurred in 7 cases and ureter perforation occurred in 2 cases. Postoperative 9 cases of severe gross hematuria, urinary tract infection in 2 cases. Two months after operation, one patient with KUB was found to remain in the renal pelvis with one patient remaining in the original site. Conclusion Holmium laser lithotripsy is safe and effective in the treatment of senile ureteral calculi. It has the advantages of small trauma, good lithotripsy results and less complications. It is a good choice for the treatment of ureteral calculi in the elderly.