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目的:总结输尿管镜钬激光治疗输尿管结石伴息肉的疗效和操作技巧。方法:回顾性分析采用钬激光经输尿管镜治疗28例输尿管结石伴息肉患者的临床资料。结果:28例患者一次碎石成功率为85.7%(24/28),一次输尿管息肉切除成功率为100%。平均手术时间50 min,术后平均住院4.5天。在碎石过程中,4例输尿管上段结石部分碎片冲入肾盂,予以留置双J管,再次行ESWL。24例患者术后拔除双J导管后随访3～6个月,KUB示残余碎石均已排净,B超检查示肾积水均有不同程度缓解,其中20例患者肾积水消失,2例患者术后6个月息肉伴结石再次复发,由于拒绝开放手术,再次行输尿管镜钬激光治疗,目前仍在密切随访中。结论:对于输尿管结石伴息肉患者,采用输尿管镜下钬激光切除息肉和碎石,可以达到满意的治疗效果。
OBJECTIVE: To summarize the efficacy and operating skills of ureteroscopic holmium laser in the treatment of ureteral calculi with polyp. Methods: The clinical data of 28 patients with ureteral calculi complicated with polyps treated with holmium laser by ureteroscope were analyzed retrospectively. Results: The success rate of primary ureteral polypectomy was 85.7% (24/28) in 28 patients and 100% in one ureter. The average operation time was 50 min and the average postoperative hospital stay was 4.5 days. In the process of gravel, 4 cases of upper ureteral calculi part of the stone into the renal pelvis, to be placed double J tube, again ESWL. Twenty-four patients were followed up for 3 to 6 months after double-J catheter removal. KUB showed that the residual gravel had been drained. B-ultrasound showed that hydronephrosis was relieved to varying degrees, of which hydronephrosis disappeared in 20 patients, 2 Cases of patients with polyps 6 months after the recurrence of polyps, due to refusal to open surgery, re-ureteroscopic holmium laser treatment, is still under close follow-up. Conclusion: For patients with ureteral calculi accompanied by polyps, ureteroscopic holmium laser excision of polyp and gravel can achieve satisfactory therapeutic effect.