评价孙氏末段可弯硬性输尿管肾镜（简称孙氏镜）联合钬激光治疗上尿路结石的疗效、安全性及操作技巧。

回顾性分析我院收治的82例孙氏镜钬激光治疗肾和输尿管上段结石的临床资料。其中男52例（63.4%），女30例（36.6%）。输尿管上段结石26例（31.7%），肾结石56例（68.3%）。患者年龄（37±11）岁，结石大小（1.4±0.6）cm。术前均经彩超、CT或静脉肾盂造影诊断为肾或输尿管上段结石，分析该术式的手术时间、术中并发症及结石清除率等。

孙氏镜单次进镜成功率95.1%（78/82），4例患者因输尿管膀胱开口处狭窄或输尿管扭曲无法进镜改为腹腔镜取石或经皮肾镜碎石（PCNL）。钬激光碎石成功率97.4%（76/78），术后4周结石清除率96.1%（73/76），3例残余结石经体外冲击波碎石（ESWL）后治愈，所有患者未出现严重并发症。

孙氏镜联合钬激光治疗肾和输尿管上段结石安全可靠、结石清除率高、并发症低。

To evaluate the efficacy, safety and operating skills of Sun's tip-flexible ureterorenoscopy(tf-URS) with holmium laser in the treatment of renal and upper ureteral calculi.

Retrospective analysis of clinical data of 82 patients with renal and upper ureteral calculi were treated with tf-URS with holmium laser in our hospital, including 52 male (63.4%) and 30 female (36.6%), and 26 cases with upper ureteral calculi(31.7%), 56 cases with renal calculi(68.3%). The age ranged from (37±11) years old. Stone size was (1.4±0.6) cm. All the patients were diagnosed by ultrasound, CT or IVP. The operative time, postoperative complications and calculi clearance rate were observed.

The success rate of insertion of tf-URS was 95.1% (78/82) in the first time. Four patients suffered ureterostenosis or ureteral distortion was changed to laparoscopy or PCNL. The success rate of lithotripsy was 97.4%(76/78) . The rate of total stone clearance was 96.1%(73/76) at 4 weeks, and 3 cases underwent ESWL. No serious complications occurred.

The tf-URS with holmium laser in the treatment of renal and upper ureteral calculi is safe, reliable and it has high success rate with low incidence of complications.