局麻下输尿管镜钬激光碎石术治疗输尿管结石的经验总结

doi:10.3969/j.issn.1671-7171.2026.07.027

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摘要 【目的】探讨局麻下输尿管镜钬激光碎石术(ureteroscopic laser lithotripsy,URSL)治疗输尿管结石的可行性和安全性。【方法】回顾性分析2023年1月至2025年9月于湖南省第三人民医院局麻下行URSL治疗的52例输尿管结石患者的临床资料,比较患者围手术期指标、手术结果、术后并发症、患者满意度。【结果】52例患者中,平均结石直径(7.12±3.36)mm,均在局麻下完成手术,42例患者行输尿管硬镜下钬激光碎石术,10例患者行输尿管软镜下钬激光碎石术。平均手术时间(13.27±6.17)min,男性手术时间为(19.71±6.52)min,长于女性手术时间的(11.13±5.01)min,差异有统计学意义(P<0.05)。术中平均视觉模拟评分法(VAS评分)(2.67±2.89)分,其中男性术中平均VAS评分为(5.50±1.50)分,高于女性的(1.66±1.99)分,差异有统计学意义(P<0.05)。男性术中发生中重度疼痛比例为72.22%(13/18),高于女性的23.53%(8/34),差异有统计学意义(P<0.05)。术中、术后均未出现严重并发症。早期结石清除率为100%。女性患者平均满意度评分高于男性患者,差异有统计学意义(P<0.05)。【结论】局麻下URSL治疗输尿管结石具有安全、高效的优势,尤其适用于输尿管中下段结石,女性患者因解剖优势,疼痛更轻、手术更快、满意度更高,可作为优先推荐人群。

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	何宇杰
	彭阳
	王梓铭
	章丁荣
	任琳
	曾志恒
	李浩
	于斌
	王欢

关键词 ：输尿管结石, 输尿管镜检查, 碎石术,激光

Abstract：【Objective】 To explore the feasibility and safety of ureteroscopic holmium laser lithotripsy (URSL) under local anesthesia in the treatment of ureteral calculi. 【Methods】 The clinical data of 52 patients with ureteral calculi who received URSL under local anesthesia in The Third People’s Hospital of Hunan Province from January 2023 to September 2025 were retrospectively analyzed. Perioperative indicators, surgical outcomes, postoperative complications and patient satisfaction were compared. 【Results】 The average stone diameter of the 52 patients was (7.12±3.36) mm. All operations were completed under local anesthesia, including 42 cases of rigid ureteroscopic holmium laser lithotripsy and 10 cases of flexible ureteroscopic holmium laser lithotripsy. The mean operative time was (13.27±6.17) min; the operative time of male patients [(19.71±6.52) min] was significantly longer than that of female patients [(11.13±5.01) min] (P<0.05). The average intraoperative VAS score was (2.67±2.89) points, and the mean intraoperative VAS score of males [(5.50±1.50) points] was higher than that of females [(1.66±1.99) points] (P<0.05). The incidence of moderate to severe intraoperative pain in males was 72.22% (13/18), which was higher than 23.53% (8/34) in females (P<0.05). No severe intraoperative or postoperative complications occurred, and the early stone clearance rate reached 100%. The average satisfaction score of female patients was statistically higher than that of males (P<0.05). 【Conclusions】 URSL under local anesthesia is safe and efficient for ureteral calculi, especially suitable for mid and distal ureteral stones. Benefiting from anatomical advantages, female patients experience milder pain and shorter operation time with higher satisfaction, and can be taken as the priority recommended population.

Key words： Ureteral Calculi Ureteroscopy Lithotripsy,Laser

收稿日期: 2025-09-22

中图分类号:

R692.4

通讯作者: ^*E-mail:wanghuan20087615@hotmail.com

引用本文:

何宇杰, 彭阳, 王梓铭, 章丁荣, 任琳, 曾志恒, 李浩, 于斌, 王欢. 局麻下输尿管镜钬激光碎石术治疗输尿管结石的经验总结[J]. 医学临床研究, 2026, 43(7): 1152-1155.
HE Yujie, PENG Yang, WANG Ziming, ZHANG Dingrong, REN Lin, ZENG Zhiheng, LI Hao, YU Bin, WANG Huan. Experience Summary of Ureteroscopic Holmium Laser Lithotripsy under Local Anesthesia for Ureteral Calculi. JOURNAL OF CLINICAL RESEARCH, 2026, 43(7): 1152-1155.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.07.027 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I7/1152

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