输尿管镜钬激光碎石术并发症探讨(附242例报告)
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摘要：目的：探讨输尿管镜钬激光碎石术并发症发生原因及处理措施。
方法：回顾分析2007年6月～2009年12月共开展输尿管镜钬激光手术242例，出现并发症共37例，发生率15.3%。其中输尿管黏膜撕裂1例，予留置双J管；输尿管穿孔并发腹膜炎1例，予开放手术并置管引流；置镜失败13例中11例改开放手术；术后尿路感染16例；结石上移冲入肾盂3例，1例改行经皮肾输尿管镜钬激光碎石术，1例于肾盂内钬激光碎石，另1例留置双J管，行体外震波碎石治疗；结石残留输尿管3例，1例行体外震波碎石治疗，另2例经随访拔除双J管2周后结石自行排出。
结果：37例均获治愈，未发生二次并发症。
结论：了解输尿管镜钬激光碎石手术并发症的原因，提高操作水平，减少并发症的发生。
关键词：输尿管镜 钬激光 并发症
The treatment and prevention of complications associated with holmium:YAG laser ureterolithotripsy
Ding Yinman Hu Zhihua Zhang Rentao et al
Abstract:Objective:To study the cause and the resolvent of complications associated with holmiu:YAG laser ureterolithotripsy.
Methods:Review242 ureteroscopy holmium:YAG laser surgery cases from June 2007 to December 2009. 37 cases were found with complications , the rate was 15.3%. one patient suffered with Ureteral mucosa tear who retained to double J tube; one patient with Ureteral surgery was peritonitis and treated with open surgery and laid tube drainage; 11 of the 13 cases which failed with installed mirror changed to open surgery. Postoperative urinary tract infections were found in 16 patients ; Stone move up to renal pelvis were found in 3 cases which switched to percutaneous renal ureteroscopy holmium:YAG laser lithotripsy, the renal pelvis holmium:YAG laser lithotripsy and the lien double J tube respectively line extracorporeal shock wae lithotripsy treatment; 3 cases with Residual ureteral stones , 1 routine extracorporeal shock wae lithotripsy treatment,the other two? cases followed up by pulling out the double J tube,the stones pass spontaneously after 2 weeks.
Result:37 cases were cured, and did not happen secondary complications.
Conclusion:The skilled operation and strict indication are important for reducing complications.
Keywords:Ureteroscope Holmium laster Complication
【中图分类号】R4【文献标识码】A 【文章编号】1008-1879(2012)07-0019-02
近年来，输尿管镜钬激光技术在泌尿外科的广泛应用促进了微创外科及腔内泌尿外科的发展 ......
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