评估安全导丝（双J管自带内置导丝）在输尿管镜治疗输尿管中下段结石中防止结石漂移的临床作用。

回顾2016年1月至2020年5月，中部战区总医院收治的输尿管中、下段结石行输尿管镜钬激光治疗的患者，共125例，其中有69例碎石术中留置安全导丝（安全导丝组）；其余56例碎石过程中未使用任何辅助碎石装置（非安全导丝组）。对两组患者的手术时间、结石清除率、术后并发症、住院费用等进行综合分析对比。

全部125例患者术后均未出现输尿管损伤及严重感染等并发症，安全导丝组的患者碎石成功率达100%，非安全导丝组的患者有4例结石漂移至肾盂，成功率93%，差异有明显统计学意义（P<0.05）；非安全导丝组患者平均手术时间为（26.3±14.7）min，安全导丝组（25.2±12.8）min，差异无明显统计学意义（P>0.05）。非安全导丝组手术费用为（11 856±1 547）元，安全导丝组为（12 126±1 013）元，差异无统计学意义（P>0.05）。

输尿管镜钬激光碎石治疗输尿管中下段结石术中应用安全导丝可有效防止输尿管结石漂移，同时有结石清除率高，安全性好，术后并发症少，不增加额外费用等特点。

To evaluate the safety and efficacy of guide wire (with built-in wire in double J tube) in preventing the migration of stones during ureteroscopic treatment of the middle and lower ureteral stones.

Clinical data of 125 patients with the middle and lower ureteral stones receiving ureteroscopic holmium laser treatment in Central War Zone General Hospital from January 2016 to May 2020 were retrospectively analyzed. Among them, guide wires were retained during lithotripsy in 69 cases (guide wire group), and no auxiliary lithotripsy device was employed in the remaining 56 patients (no guide wire group). The operation time, stone removal rate, postoperative complications and hospitalization expenses were statistically compared between the two groups.

No postoperative complications, such as ureteral injury and severe infection occurred. The success rate of lithotripsy was 100% in the guide wire group, significantly higher than that in the no guide wire group 93% (P<0.05). The average operation time in the no guide wire group was (26.3±14.7) min, which did not significantly less than the guide wire group (25.2±12.8) min (P>0.05). There was no difference in operation cost between the two group.

Application of guide wire can effectively prevent the migration of ureteral stones during ureteroscopic holmium laser lithotripsy for the middle and lower ureteral stones. Moreover, it has the advantages of high stone removal rate, high safety, few postoperative complications and no additional expenses.