目的 评价NForce取石网篮联合输尿管镜钬激光碎石在输尿管镜碎石中的应用效果。方法 回顾分析2018-06至2020-07医院收治的输尿管镜碎石术联合NForce取石网篮治疗的71例患者的临床资料,平均(45.80±11.99)岁,结石径线(13.05±4.30) mm,最大结石径线27.97 mm,结石表面积(66.86±60.04)mm²,CT值(447.68±286.50)HU。患者手术均由同一组医师完成,术后复查KUB显示残石径线＜4 mm,且患者无临床症状者视为结石完全清除。分析患者的结石清除率和并发症。结果 所有患者均完成手术治疗,一期结石清除率为93.0%。出现输尿管穿孔2例,镍钛合金丝断裂2例,其中行经腰输尿管切开异物取出术1例,行输尿管镜下异物钳夹闭取出术1例,术后经过延长双J管时间,后期复查未出现输尿管狭窄。结论 NForce取石网篮联合输尿管镜钬激光碎石临床效果显著,安全性高,是处理输尿管结石的可靠手术方案。

Objective To evaluate the applicability of NForce stone extraction baskets combined with ureteroscopic holmium laser lithotripsy in ureteroscopic lithotripsy. Methods The clinical data on 71 patients who underwent ureteroscopic lithotripsy combined with NForce stone extraction baskets was collected in Hospital 904 of Joint Logistic Support Force of PLA between June 2018 and July 2020. The average age of these patients was (45.80±11.99) years old. the average diameter of stones was (13.05±4.30)mm, the maximum diameter was 27.97 mm, the average surface area was (66.86±60.04)mm², and the CT average value was (447.68±286.50)HU. All the operations were performed by the same surgeons. Patients whose postoperative follow-up KUB showed that the diameter of the stone was <4 mm and who were asymptomatic were considered cases of complete stone clearance. Finally, the stone clearance rate and incidence of complication of these patients were analyzed. Results All the operations were successful, and the primary stone clearance rate was 93.0%. Two patients had ureteral perforation. Moreover, two patients had nitinol wire breakage, one of whom was treated with translumbar ureterotomy for foreign body removal and the other with ureteroscopic foreign body clamp removal. By prolonging the double J tube time, no ureteral stenosis was found during subsequent visits. Conclusions The NForce stone basket combined with ureteroscopic holmium laser lithotripsy is highly effective and safe, which is a reliable approach to ureteral calculi.