摘要
目的探讨输尿管软镜联合钬激光碎石治疗肾结石及输尿管上段结石的临床疗效。方法选择输尿管上段结石及肾结石患者231例264侧,采用输尿管软镜联合钬激光碎石术治疗。结石直径10～25（15.1±5.6）mm。寻及结石后,使用200μm光纤及365μm光纤功率碎石。结果一次碎石成功率85.3%（197/231）,总清石率94.8%（219/231）。输尿管上段[98.2%（55/56）]、肾上盏[97.0%（65/67）]、肾中盏[94.1%（32/34）]及肾盂结石[96.3%（26/27）]清石率明显高于肾下盏[80.0%（12/15）]及多肾盏结石[90.6%（29/32）]。手术时间12～65 min,平均41 min。住院时间1～4 d,平均3 d。术后5例发热,无其他严重并发症。结论输尿管软镜联合钬激光碎石治疗10～25 mm上尿路结石具有创伤小、安全及有效的特点,碎石率高,并发症少,可作为经皮肾镜碎石取石术后残留结石和体外冲击波碎石失败的首要选择。
Objective It is to evaluate the clinical effects of flexible ureteroscopy combined with holmium laser lithotripsy for upper urinary tract calculi. Methods Flexible ureteroseopy combined with holmium laser lithotripsy was undertaken for 231 eases of upper urinary tract calculi. The diameter of the stones ranged from 10 - 25 mm with a mean of 15.1 mm. After the u- reter was dilated, the stones were fragmentized and removed by using 200 p,m or 365 p,m optical fiber. Results Successful flexible ureteroscopy combined with holmium laser lithotripsy was achieved on one session in 197 cases （85.3%） , the total success rate of the upper urinary tract calculi free was 94. 8%. The clear rates of upper uretal calculi [98.2% （55/56） ] , upper calyx calculi [97.0% （65/67） ], middle calyx calculi [94.1% （32/34） ] and pelvis [96.3% （32/34） ] were significantly higher than that of down calculi [ 80.0% （ 12/15 ） ] and multi-calyx calculi [ 90.6% （29/32） ]. The operation time was 12 -65 minutes with a mean of 41 minutes. The mean hospital stay of the patients was 3 days （1 -4 days）. After the operation, 5 patients suffered from fever, no severe complications was observed. Conclusion Holmium laser lithotripsy through a flexible ureteroscope is a safe, minimally invasive, and effective treatment for upper urinary tract calculi especially for patients with minor stones. It is a better option for managing ESWL failed and PCNL residual calculi.
出处
《现代中西医结合杂志》
CAS
2016年第4期354-356,420,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
2014年广东省医学科研基金项目(A2014634)
2014年深圳市卫生计生系统科研项目(201401002)
关键词
输尿管软镜
钬激光
碎石
上尿路结石
flexible ureteroscopy
holmium laser
lithotripsy
upper urinary tract calculi
