王海洋

[摘要] 目的 探討输尿管镜下钬激光碎石术治疗输尿管结石的临床效果。 方法 对2016年1月～2019年12月本院治疗的69例输尿管结石患者的临床资料进行分析，将其中接受输尿管镜下钬激光碎石术治疗的34例患者归入钬激光组，接受输尿管镜下气压弹道碎石术治疗的35例患者纳入气压弹道组，对比分析两组围术期相关指标、一次碎石成功率、结石排净率及手术后并发症发生情况。 结果 钬激光组手术时长、术后血尿维持时长、术后住院治疗天数及术后48 h的VAS评分均低于气压弹道组，差异显著（P<0.05）。钬激光组一次碎石成功率和结石排净率均为100.00%，分别高于气压弹道组的80.00%和88.57%，差异均有统计学意义（P<0.05）。钬激光组术后并发症发生率低于气压弹道组（2.94% vs 20.00%，P<0.05）。 结论 相比于输尿管镜下气压弹道碎石术，输尿管镜下钬激光碎石术治疗输尿管结石的手术时间和住院时间较短，术后疼痛较轻，排石效果更优，安全可靠。

[关键词] 输尿管镜;输尿管结石;钬激光碎石术;气压弹道碎石术

[中图分类号] R699.4          [文献标识码] B          [文章编号] 1673-9701（2020）17-0044-04

A study of the treatment of ureteral calculi with holmium laser lithotripsy under ureteroscope

WANG Haiyang

Department of Urology Surgery， Xinyi Peoples Hospital in Jiangsu Province， Xinyi   221400， China

[Abstract] Objective To investigate the clinical efficacy of the treatment of ureteral calculi with holmium laser lithotripsy under ureteroscope. Methods The clinical data of 69 patients with ureteral calculi treated in our hospital from January 2016 to December 2019 were analyzed. Among them， the 34 patients treated with holmium laser lithotripsy under ureteroscope were classified into the holmium laser group and the 35 patients treated with pneumatic ballistic lithotripsy under ureteroscope were taken as the pneumatic ballistic group. The perioperative related indexes， success rate of one-time lithotripsy， stone removal rate and postoperative complications of the two groups were compared and analyzed. Results The operation duration， postoperative hematuria maintenance duration， postoperative hospitalization days and VAS scores 48 h postoperatively of the holmium laser group were significantly lower than those of the pneumatic ballistic group， and the differences were significant（P<0.05）. The success rate of one-time lithotripsy and the stone removal rate of the holmium laser group were both 100.00%， respectively higher than the 80.00% and 88.57% of the pneumatic ballistic group， and the differences were both statistically significant（P<0.05）. The incidence of postoperative complications of the holmium laser group was lower than that of the pneumatic ballistic group（2.94% vs 20.00%， P<0.05）. Conclusion In the treatment of ureteral calculi， compared with pneumatic ballisticlithotripsy under ureteroscope， holmium laser lithotripsy under ureteroscope requires shorter operation time and hospitalization time， incurs less postoperative pain， and has better stone removal effect. It is safe and reliable.

[Key words] Ureteroscope; Ureteral calculus; Holmium laser lithotripsy; Pneumatic ballistic lithotripsy

输尿管结石是泌尿外科常见疾病之一，患者多表现为疼痛、血尿等症状，部分输尿管结石患者存在息肉及梗阻状况，病情加重时可损伤肾脏功能，导致输尿管结石患者机体健康情况严重受损，引发输尿管结石患者日常生活质量下降[1-2]。临床上多为输尿管结石患者实行手术治疗，输尿管镜下钬激光碎石术、输尿管镜下气压弹道碎石术均是临床上输尿管腔中碎石手术常见治疗方式。本研究目的是为了分析输尿管镜下钬激光碎石术治疗输尿管结石患者的临床情况。本研究即对2016年1月～2019年12月本医院治疗的69例输尿管结石患者的临床资料进行对比分析，分别实行输尿管镜下气压弹道碎石术治疗方案、输尿管镜下钬激光碎石术治疗方案，对比两种治疗方案所获得的手术治疗效果，以期为该病的临床治疗提供借鉴和参考，进而改善输尿管结石患者的预后情况。……