摘要
目的评价超脉冲光纤铥激光碎石术腔内治疗泌尿系结石的有效性和安全性。方法2021年5月至2022年7月间,在4家医疗中心前瞻性纳入符合条件的泌尿系结石患者,采用超脉冲光纤铥激光治疗机经内窥镜直视下碎石,记录患者围手术期情况,主要的有效性指标为术后4周的结石清除率(SFR),主要的安全性指标为术中试验器械的故障发生率,次要的安全性指标为围手术期并发症发生率。结果共76例符合条件的患者完成了超脉冲光纤铥激光碎石术,患者年龄(52.0±11.1)岁,男54例,女22例。肾结石31例,输尿管结石43例,膀胱结石2例。17例患者行经皮肾镜取石术,57例患者行输尿管硬/软镜碎石术,2例患者行经尿道膀胱碎石取石。所有患者的碎石时间为(50.9±31.4)min,术中未出现试验器械故障。6例患者拒绝术后的随访检查。术后不良事件发生率为61.8%(47/76),1例患者术后因腹股沟疝需住院治疗,其余均为Clavien‑dindo分级1~2级。术后4周SFR为94.3%(66/70)。结论超脉冲光纤铥激光治疗机用于泌尿系结石的腔内治疗是有效、安全的。
Objective To evaluate the efficacy and safety of superpulse thulium laser lithotripsy in the intracavitary treatment of urinary calculi.Methods From May 2021 to July 2022,patients diagnosed with urinary calculi were screened in four medical centers.Those who met the criteria were treated with superpulse thulium fiber laser under endoscope.The patients′perioperative conditions were recorded.The main effective index was stone‑free rate(SFR)4 weeks after operation,the main safety index was the failure rate of the experimental instruments during operation,and the secondary safety index was the incidence rate of perioperative complications.Results A total of 76 eligible patients completed superpulse thulium fiber laser lithotripsy,with an average age of(52.0±11.1)years,54 males and 22 females.There were 31 renal stones,43 ureteral stones and 2 bladder stones.Percutaneous nephrolithotomy was performed in 17 patients.Ureteroscopy lithotripsy/flexible ureteroscopy lithotripsy was performed in 57 patients and transurethral bladder lithotripsy was in 2 patients.The lithotripsy time of all patients was(50.9±31.4)minutes.There was no failure of experimental instruments during the operation.Six patients refused follow‑up examination after operation.The incidence of postoperative adverse events was 61.8%(47/76).One patient needed hospitalization due to inguinal hernia after operation,and the rest were classified as Clavien‑dindo grade 1‑2.The SFR was 94.3%(66/70)at 4 weeks after operation.Conclusion It is effective and safe to use superpulse thulium fiber laser in the treatment of urinary calculi.
作者
刘成
邵怡
夏磊
余虓
许可慰
Liu Cheng;Shao Yi;Xia Lei;Yu Xiao;Xu Kewei(Department of Urology,Sun Yat‑sen Memorial Hospital,Sun Yat‑sen University,Guangzhou 510120,China;Department of Urology,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Urology,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shangghai 200127,China;Department of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2023年第30期2302-2306,共5页
National Medical Journal of China
基金
广东省重点领域研发计划(2020B1111140002)
广州市科技计划(20201102004、201803010029)
关键词
结石
铥
泌尿生殖系统
超脉冲光纤铥激光治疗机
腔内碎石
Calculi
Thulium
Urogenital system
Superpulse thulium fiber laser
Endoscopic lithotripsy
