摘要
目的:探讨一期组合式输尿管软镜钬激光碎石术治疗双侧肾结石的临床疗效及安全性。方法:2010年1月～2012年1月采用德国铂立组合式输尿管软镜联合钬激光一期治疗双肾结石患者20例,结石大小0.7～2.0cm,平均1.3cm。含有大于1cm肾结石12例。20例均为双肾结石,含结石68枚,位于肾上盏13枚,中盏17枚,下盏18枚,肾盂20枚。结果:本组20例双肾结石均顺利完成一期双侧手术。一次手术结石清除率为80.0%(32/40)。本组总结石寻及率95.6%(65/68)。其中上、中盏及肾盂结石寻及率100%,单次碎石成功率92.0%(46/50);下盏结石寻及率83.3%(15/18),单次碎石成功率72.2%(13/18)。一期双侧手术总时间70～120min,平均90min。术中无输尿管穿孔等严重并发症发生。住院时间3～7d,平均4.2d。术后随访3～6个月,KUB或CT未见结石复发。结论:双肾结石采用输尿管软镜钬激光碎石术治疗安全、有效。尤其对于肾结石体积较小患者,可实施一期治疗双肾结石,以缩短治疗周期,减少费用。
To evaluate the efficacy and safety of Holmium laser lithotripsy with flexible uretero- scope for bilateral renal calculi. Method：From January 2010 to January 2012, we performed Holmium laser lithotripsy with of a newly designed modular flexible ureteroscope for 20 patients with bilateral renal calculi. The diameter of the calculi ranged from 0.7 to 2.0 cm （mean 1.3 cm ）. Result：In 20 patients（40 sides） ,the stone-free rate was 80.0% （32/40） on one session. In 12 patients with calculi larger than 1 cm, the stone-free rate was 70.8%（17/24）. 20 cases had 68 stones. All of the 50 stones in upper, middle calyx or pelvis had been found. And the successful fragmentation rate was 92.0%（46/50）. The stone access rate of the 18 stone in lower calyx was 83.3% （15/18）. And the fragmentation rate was 72.2%（13/18）. No major complications were observed. The mean operation time for bilateral renal calculi was 90 min （ranged from 70 to 120 rain）. The patients were discharged from hospital in 3 to 7 days, and then were followed up for 3 to 6 months. During the follow-up, KUB and CT found no recurrence of calculi. Conclusion： Holmium laser lithotripsy with flexible ureteroscope is effective and safe for bilateral renal calculi up to 2 cm. With satisfying stone free rate and negligible complications＂ rate, simultaneous Holmium laser lithotripsy with flexible ureteroscope performed on bilateral renal calculi can shorten the cycle time of treatment and hospitalization.
出处
《临床泌尿外科杂志》
2013年第5期345-347,共3页
Journal of Clinical Urology
关键词
肾结石
输尿管软镜
钬激光
安全性
有效性
renal calculi
flexible ureteroscope
holmium laser lithotripsy
safety
effectiveness
