输尿管软镜下钬激光碎石治疗体外震波碎石失败后复杂性输尿管结石临床探讨.docVIP

输尿管软镜下钬激光碎石治疗体外震波碎石失败后复杂性输尿管结石临床探讨 　　[摘要] 目的 探讨输尿管软镜下钬激光碎石治疗体外震波碎石失败后复杂性输尿管结石的临床效果。方法 选取2014年2月―2014年12月期间该院收治的复杂性输尿管结石患者80例，其中40例体外震波碎石失败后使用微创经皮肾穿刺取石+术（MPCNL）的患者作为对照组，另外40例体外震波碎石失败后使用输尿管软镜下钬激光碎石治疗的患者作为研究组，分析研究两组的治疗效果。结果 对照组患者碎石成功率为95.0%（38/40），研究组患者中碎石成功率为92.50%（37/40），上段结石成功率80.00%（8/10），中段结石成功率90.00%（9/10），下段结石成功率95.00%（19/20），失败3例，占7.50%（3/40），研究组与对照组碎石成功率之间差异无统计学意义（P0.05）。其中有2例冲入肾盂后再次经输尿管软镜下钬激光碎石治疗，1例通过后腹腔镜下输尿管结石切开取石的方式取石，手术中输尿管穿孔1例，手术平均时间（65±15.50）min，住院时间（7.50±1.50）d。结论 输尿管软镜下钬激光碎石是一种治疗体外震波碎石失败后复杂性输尿管结石的可靠手段，临床应用前景广阔。 　　[关键词] 输尿管软镜；钬激光；输尿管结石；体外震波碎石 　　[中图分类号] R693.4 [文献标识码] A [文章编号] 1674-0742（2015）06（a）-0069-02 　　Clinical Observation on Holmium Laser Lithotripsy Under Flexible Ureteroscope for Complexity Ureteral Calculi After Failed Extracorporeal Shock-wave Lithotripsy 　　YAO Ya-xiong， LU Jian-lu， JI Qiang， WANG Yong-qing， LIN Lin 　　Department of Urinary Surgery， Second Peoples Hospital of Jiaozuo（First Affiliated Hospital of Henan Polytechnic University） ， Jiaozuo， Henan Province， 454000 China 　　[Abstract] Objective To evaluate the efficacy of the holmium laser lithotripsy under Flexible ureteroscope for the complexity ureteral calculi after failed extracorporeal shock-wave lithotripsy（ESWL）. Methods 80 complexity ureteral calculi patients were divided into control group and study group during February 2014 to December 2014， 40 patients after failed ESWL treated with MPCNL as control group and 40 after failed ESWL treated with holmium laser lithotripsy under ureteroscope as study group. Compared the successful rates and failure rates. Results The success rate in the control group was 95.0%（38/40）and in the study group the overall stone-free rate was 92.50%（37/40）， and the successful rate was 80.00%（8/10）in the upper segment， 90.00%（9/10）in the middle segment， 95.00%（19/20）in the lower segment， 7.50%（3/40） failed. The differences of the success rate between the study group and the control group was not statistically significant（P0.05）. 2 of them were