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目的探讨侧卧位输尿管镜钬激光碎石术治疗输尿管上段结石的疗效和安全性。方法回顾性分析行侧卧位输尿管镜钬激光碎石术治疗212例输尿管上段结石患者的临床资料。结果 205例1次碎石成功,成功率96.7%;7例手术失败,3例因肾积水、灌注水流大、结石进入肾盏所致,4例因输尿管弯曲较大、输尿管镜无法进入所致。术中3例发生输尿管穿孔;8例因输尿管下段狭窄致进镜困难,后行输尿管扩张成功操作。术后4周结石排净202例,排净率98.54%;3例于输尿管下段有石街形成。结论侧卧位输尿管镜钬激光碎石术治疗输尿管上段结石安全、有效,可作为输尿管上段结石首选治疗方法。
Objective To investigate the efficacy and safety of lateral ureteroscopic holmium laser lithotripsy in the treatment of upper ureteral calculi. Methods The clinical data of 212 cases of upper ureteral calculi treated by ureteroscopic holmium laser lithotripsy were retrospectively analyzed. Results A total of 205 cases of primary gravel were successfully treated with a success rate of 96.7%. Seven cases failed surgery and three cases were caused by hydronephrosis and perfusion water flow. Calculus into the calyce caused by stones in 4 cases. Ureteroscopy To 3 cases of intraoperative ureteral perforation occurred; 8 cases due to lower ureteral stricture into the mirror difficult, the successful operation of ureteral dilatation. Four weeks after operation, the stone was drained 202 cases, the discharge rate was 98.54%. Three cases were formed in the lower ureter with stone street. Conclusion The treatment of lateral ureteroscopic holmium laser lithotripsy for upper ureteral calculi is safe and effective and can be used as the first choice for the treatment of upper ureteral calculi.