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目的:探讨钬激光治疗输尿管结石并发息肉的临床疗效及并发症的预防。方法:回顾性分析2007年5月～2008年12月我科行输尿管镜下钬激光治疗输尿管结石并发息肉11 5例临床资料。结果:一次性息肉切除并碎石成功98例;例息肉切除时结石上移至肾盂内12,术后1周行体外冲击波碎石治疗,效果良好;5例输尿管上段呈N型折叠成角,息肉烧灼时致输尿管穿孔而改开放手术治疗。平均手术时间46 min(16～80 min),平均住院时间7天(4～11天)。95例随访6个月～1年,复查静脉肾盂造影显示输尿管通畅,未见明显结石残留。结论:腔内钬激光同时治疗输尿管息肉并发结石安全、有效、确切,规范、轻柔、熟练的操作技巧是预防和减少并发症发生的关键。
Objective: To investigate the clinical efficacy of holmium laser in the treatment of ureteral calculi complicated with polyps and the prevention of complications. Methods: The clinical data of 115 cases of ureteral calculi complicated with polyps treated by ureteroscopic holmium laser under our department from May 2007 to December 2008 were retrospectively analyzed. Results: One-off polypectomy and lithotripsy were successfully performed in 98 cases. When polyp excision, the calculus was moved to the renal pelvis 12, and 1 week after operation. The extracorporeal shock wave lithotripsy was performed with good results. In the upper ureter, Polyps caused by perforation of the ureter perforation change open surgery. The average operation time was 46 min (16 ~ 80 min) and the average length of stay was 7 days (4 ~ 11 days). 95 cases were followed up for 6 months to 1 year, review of intravenous pyelography showed ureteral patency, no significant residual stones. Conclusion: Holmium laser treatment of ureteral polyps complicated with stones safe, effective, precise, standardized, gentle, skilled operation skills is the key to prevent and reduce the incidence of complications.