摘要
目的 :探讨钬激光输尿管碎石手术失败的原因。方法 :报告以钬激光经输尿管镜进行输尿管结石碎石手术失败的 8例临床资料。结果 :8例中 3例由于术中结石移位致使结石进入肾盂 ,无法继续碎石 ;2例由于输尿管走行迂曲或输尿管狭窄 ,输尿管镜无法通过而放弃手术 ;1例由于结石阻塞输尿管 ,冲洗液引流不畅导致手术视野不清而停止手术 ;2例因为输尿管开口内陷 ,置镜受阻而终止手术。结论 :结石移位、输尿管走行迂曲或狭窄、手术视野不清及输尿管开口异常导致置镜失败 ,是该手术失败的主要原因。术前合理选择病例 ,使用适宜光纤 ,术中适时调整冲洗液流速、压力及激光的参数 ,从结石边缘起碎石等措施是提高手术成功率的关键。
Objective:To assess the causes of the failure of holmium:YAG laser ureterolithotripsy.Methods:Fifty-three patients underwent retrograde ureteroscopic laser lithotripsy by ureteroscopes and the holmium∶YAG laser (Coherent Co).Results:Eight patients failed to fragment the ureteral stones completely,3 cases were abandoned because of the stone migrations to the renal pelvis, 2 cases were stopped owing to the tortuosity or the narrow of the ureters, 1 case failed because operation area was not clear, 2 cases were halted due to the invagination of the opening of the ureters.Conclusions:The main causes of the failure of the homium:YAG laser ureterolithotripsy are stone migrations, tortuous or narrow ureters, unclear operation area and the invagination of the opening of the ureters. Suitable cases, fitting optical fibers, appropriate flow rate and pressure of the fluid and laser parameters are important measures to elevate the success rate.
出处
《临床泌尿外科杂志》
2004年第1期11-12,共2页
Journal of Clinical Urology
关键词
钬激光
输尿管结石
碎石术
Holmium laser
Ureteral calculi
Lithotripsy
