标题：输尿管封堵导管在输尿管中上段结石钬激光碎石中的应用

      作者：郝继东，廖国强，邓晓俊，刘辉，刘峰，王伟峰
    (上海健康医学院附属周浦医院泌尿外科，上海 201318)

      卷次： 2016年27卷15期

      【摘要】 目的 探讨输尿管封堵导管在输尿管中上段结石钬激光碎石(URL)治疗中的有效性及安全性。
方法 回顾性分析上海健康医学院附属周浦医院泌尿外科2011年8月至2015年9月期间收治的120例输尿管中
上段结石使用封堵导管行URL患者的临床资料。结果 120例患者中112例成功粉碎结石，结石清除率为93.3%，
其中3例术中未能成功封堵结石，结石漂移至肾孟，术中留置双 J管，后两期行输尿管软镜碎石。还有1例患者输尿
管结石较大且嵌顿明显，输尿管周围无空隙叶片无法绕过结石，术中出血视野模糊，后行输尿管切开取石。另外4
例术后复查有输尿管结石残留术后补充行体外震波碎石(ESWL)或再次行输尿管硬镜碎石，所有患者均无输尿管
黏膜撕脱及输尿管穿孔等严重并发症。结论 输尿管封堵器协助治疗输尿管中上段结石方法有效，操作简便，减
少结石移动，提高结石清除率，不增加手术并发症，具有良好的临床应用价值。

      【关键词】 输尿管中上段结石；封堵导管；钬激光

      【中图分类号】 R693+.4 【文献标识码】 A 【文章编号】 1003—6350（2016）15—2537—03


Application of ureteral occlusion device in ureteroscopic holmium laser lithotripsy for upper ureteral stones.
HAO
Ji-dong, LIAO Guo-qiang, DENG Xiao-jun, LIU Hui, LIU Feng, WANG Wei-feng. Department of Urology, Zhoupu Hospital
Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai 201318, CHINA

【Abstract】 Objective To explore the curative effectiveness and safety of ureteral occlusion device in uretero-
scopic holmium laser lithotripsy for upper ureteral stones. Methods The clinical data of 120 patients admitted to De-
partment of Urology of Zhoupu Hospital Affiliated to Shanghai University of Medicine and Health Sciences from Au-
gust 2011 to September 2015, who underwent ureteral occlusion device combined with ureteroscopic holmium laser lith-
otripsy for upper ureteral stones, was retrospectively analyzed. Results The calculi of 112 cases among the 120 patients
were smashed successfully with a clearance rate of 93.3%. Calculi in three cases were not occluded successfully during op-
eration and shifted to renal pelvis. The double J tube was placed during the operation and flexible ureteroscope lithotripsy
was operated in the last two-stage. Also there was one case that the blade can not be placed over the calculus for which
was too big and obvious embedding, so that no space around the ureter cannot bypass the stone. There was bleeding caus-
ing blurred vision. Then, the calculus was removed by incision of ureter. The other four cases with the remaining ureter cal-
culi were operated with extracorporeal shock wave lithotripsy (ESWL) or rigid ureteroscope lithotripsy again. None of the
patients had serious complications such as ureter mucosa avulsion or piercing. Conclusion Ureteral occlusion device is
effective in assisting in ureteroscopic holmium laser lithotripsy for upper ureteral stones. This method is easy to operate
and can reduce the movement of calculi, increase calculi clearance rate without increasing complications, and thus has a
good clinical application value.

      【Key words】 Middle and upper ureteral stones; Occlusion device; Holmium laser
·临床经验·
6350.2016.15.044