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目的探讨输尿管硬镜联合钬激光、套石篮治疗输尿管中上段结石的手术方法及术中注意事项。方法选取该院2012年10月—2015年4月收治的输尿管中上段结石92例,均采用输尿管硬镜联合钬激光碎石技术,其中26例使用套石篮。结果 92例患者中,一次性碎石成功79例,13例结石上移入肾盂,在26例使用套石篮的患者中仅有1例结石上移。术后均留置双“J”管,后期行体外冲击波或输尿管软镜碎石治疗。结论本组患者中,一次性碎石成功率达85.86%,使用套石篮后一次性碎石成功率可达96.15%。输尿管硬镜联合钬激光、套石篮手术方式创伤小,可有效降低结石上移率,降低术后结石残留率,明显提高一次性碎石成功率。在治疗输尿管中上段结石中值得推广。
Objective To investigate the operative methods and intraoperative precautions of ureteral calculi combined with holmium laser and sheath stone basket in the treatment of upper ureteral calculi. Methods 92 cases of upper and middle ureteral stones admitted from October 2012 to April 2015 in our hospital were treated with ureteroscopic combined with holmium laser lithotripsy, of which 26 cases were made of stone baskets. RESULTS Of the 92 patients, 79 had a one-off gravel success and 13 had metastasized to the renal pelvis. Only 1 of 26 patients with stone baskets had stones moved up. Postoperative double “J ” tube, postoperative extracorporeal shock wave or ureteroscopic lithotripsy. Conclusion The success rate of one-time lithotripsy in this group of patients is 85.86%, and the success rate of one-time lithotripsy after using one of them is 96.15%. Ureteroscopic combined with holmium laser, sheath stone basket surgical trauma, can effectively reduce the rate of stone move, reduce the residual rate of postoperative stones, significantly improve the success rate of one-time lithotripsy. In the treatment of upper ureteral stones worth promoting.