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1应用 U100 激光腔内碎石术治疗输尿管及膀胱结石的临床观察【摘要 】 目的 探讨输尿管镜下应用 U100 激光治疗输尿管及膀胱结石的疗效。方法 对 25 例输尿管结石和 5 例膀胱结石患者在输尿管镜下应用 U100 激光进行碎石治疗。术中激光输出功率为120 mj,频率为 35 Hz,输尿管结石患者术中均留置“双 J”管引流,4 周后拔除。结果 23 例输尿管结石及 5 例膀胱结石患者一次碎石成功,72 h 内排尽结石。有 2 例输尿管上段结石患者 1 例术中结石移入肾盂,另 1 例激光碎石无效,术后均行 ESWL 治疗成功。U100 激光碎石成功率达 933% 。全部碎石成功的患者术后除出现血尿以外,无其他明显并发症出现。结论 输尿管镜下应用U100 激光碎石是一种快速,高效,安全,微创的腔内碎石方式。 【关键词】 U100 激光;激光碎石;输尿管镜;输尿管结石;膀胱结石Abstract: Objective To evaluate the clinical use of ureteroscope U100 laser lithotripsy on the treatment of ureter and bladder stones. Methods Twentyfive cases of ureter stones and five cases of bladder stones were treated 2with ureteroscope U100 laser lithotritor. The export power of the laser was 120mJ, the frequency of the laser was 35Hz. The doubleJ catheter was used for drainage after lithotripsy, and was pulled out four weeks later. Results Twentythree cases of uerter stones and five cases of bladder stones were successfully treated. The stones were ejected in 72 hours. One case with upper section stone of ureter was successful in pushing it into renal pelvis, and the other one failed to be treated by the U100 laser. The successful rate of the U100 laser lithotritor was 93.3%. All successful ones had no complications except haematuria. Conclusion Treatment of ureter stones with ureteroscope U100 laser lithotritor is quick, effective, safe and less invasive.Key words: U100 laser; laser lithotripsy; ureteroscope; ureter stone; bladder stone我院于 2005 年 712 月应用 U100 激光腔内碎石治疗输尿管结石 25 例,膀胱结石 5 例,治疗效果满意,有高效,安全,快速等优点,现将治疗结果报告如下。1 资料与方法311 临床资料本组 30 例患者中男性 18 例,女性 12 例,年龄 1876 岁,平均 365 岁,左侧输尿管结石 15 例,右侧输尿管结石 10 例,膀胱结石 5 例,输尿管上段结石 7 例,输尿管下段结石 18 例,结石直径 1230 cm,平均 19 cm。所有输尿管结石患者术前均行 ESWL 治疗,效果欠佳,其中 2 例患者输尿管内形成石街。12 治疗方法 应用德国 W0 M 公司生产的 U100 双波长激光碎石机,德国 WOLF 8/98Fr10 度输尿管硬镜,病人在连续硬膜外麻醉下(除 1 例患者因脊柱严重弯曲行全麻)进行碎石。术中激光功率设置为 120 mj,频率为 35 Hz。患者均取截石位,自尿道外口插入输尿管镜,在斑马导丝引导下将输尿管镜顺利插入患侧输尿管内,找到结石后插入激光传导光纤,如为 1 cm 以下的小结石可从结石中央将其击碎。对1 cm 的结石可先从结石边缘小块状击碎,待剩余一半大小时从中央将其完全击碎。碎石完全后在斑马导丝引导下逆行插入“双 J”管,并留置导尿管持续膀胱冲洗。导尿管术后35 d 拔除,双 J 管术后 4 周拔除。
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