Transureteroscopic Holmium:YAG Laser Lithotripsy For The Treatment Of Upper Ureteral Calculi In35Cases Analysis

Objective:To analyze35upper ureteral calculi cases which were treated by ureteroscopic holmium:YAG laser lithotripsy combined therapy with Chinese medicine row of stone, Assessment the curative effect, the success rate and safety by ureteroscopy holmium laser lithotripsy combined with traditional Chinese medicine auxiliary in the treatment of upper ureteral calculi, discuss the factors involved in successful operation, operation process should pay attention to matters, and postoperative adjuvant therapy plan.Method:Choose35upper ureteral calculi cases from Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine in2012.01-2013,02, all the cases were treated by ureteroscopic holmium:YAG laser lithotripsy combined therapy with Chinese medicine row of stone. Comparison the gender, age, stone left and right side of the position,the stone size, merger of ureteral polyps, merge ureter stenosis or circuity, preoperative hydronephrosis, preoperative renal function, preoperative ESWL relationship between successful operation and the influence factors, such as history, observe and analyze the treatment effect, and complications.Result:35cases of patients with27cases a period of gravel is successful,a period of gravel success rate77.1%(27/35). postoperative application of traditional Chinese medicine treatment of4weeks to review, stone free rate91.4%(32/35).Continue to application of traditional Chinese medicine (TCM) row of stone calculus treated by ESWL treatment stone free rate97.14%(34/35), continue to analysis showed that sex, age, preoperative renal function, and stone in left and right side of the position before ESWL factors such as history and successful operation with no correlation; The stone size, merger of ureteral polyps, merge ureter stenosis or circuity, degree of preoperative hydronephrosis factors are associated with successful operation.The group study surgical success rate of97.1%, one cases into by the failure the recent mild complications occurrence rate of14.28%, up to the two cases of upper ureteral calculi intraoperative intrapelvic0cases of perforation,O cases of avulsion.4cases of submucosal lesions,2cases (I case included in the submucosal injury patients) high fever (T≥39℃) to anti-inflammatory symptomatic treatment improved,2cases (included in the four cases of submucosal lesions) had gross hematuria cured with/without waist colic, to traditional Chinese medicine treatment of row of stone, and a diuretic, anti-inflammatory treatment, the postoperative recently found no serious complications.Conclusion:Ureteroscopy holmium laser lithotripsy combined use of Chinese medicine on the treatment of upper ureteral calculi is a safe and effective modern treatment with high success rate, is critical to the success of the surgery, choosing appropriate cases. Operation success and stone size, merger of ureteral polyps, merge ureter stenosis or circuity, correlated with factors such as degree of hydronephrosis, and patients’ gender, age, preoperative renal function, and stone in left and right side of the position before ESWL factors such as history and no significant correlation. By increasing the operation experience, improve operation skills can reduce the incidence of complications. Postoperative application of traditional Chinese medicine auxiliary line of stone fragments therapy may be beneficial to residual calculi discharge, compared with similar studies, net significantly improved the success rate of stone.