摘要
目的评估输尿管软镜下钬激光碎石术同期治疗双侧不超过1.5cm肾结石的安全性和有效性。方法回顾性分析2013年12月至2015年6月收治的86例双肾结石患者的临床资料,同期接受了双侧输尿管软镜下钬激光碎石术,术中留置输尿管软镜鞘,引入输尿管软镜进行钬激光碎石,首先处理肾结石比较小的一侧,术后1月评估结石清除率。碎石成功率被定义为结石完全被清除或残留碎片小于4mm,必要时则采取二期输尿管软镜碎石术。结果本组研究中共有86例患者,男性56例,女性30例;平均年龄(38.2±14.2)岁,结石平均直径(11.2±2.6)mm,平均碎石时间(49.08±13.06)min。首次结石清除率86.04%,第二次结石清除率96.51%。9例(10.4%)患者出现了发热等并发症,研究组中均未出现输血等严重的并发症,术前和术后的血清肌酐水平无统计学差异。结论输尿管软镜钬激光碎石术同期治疗不超过1.5cm的双肾结石具有很高的安全性和有效性,具有一定的临床推广价值。
Objective To evaluate the effectiveness and safety of bilateral single-session retrograde intrarenal surgery （RIRS） in the treatment of renal stones up to 1.5 cm. Methods Clinical data of 86 patients who underwent bilateral single- session RIRS during Dec. 2013 and Jun. 2015 were retrospectively analyzed. To fragmentize the stone, ureteral access sheath was insered into ureter before Holium laser was used, where the side with smaller stone burden was treated firstly. The free stone rate was examined one month after operation. The success rate was defined as absence of stone, or residual fragments 〈 4 mm. To remove residual stones, second-stage surgery was carried out. Results A total of 86 patients （56 male, 30 female） with a mean age 38.2± 14.2 were included in the study. The mean stone size was （11.2 ± 2.6）mm. The stone-free rate was 86.04% and 96.51% after the first and second procedure, respectively. Minor complications such as fever were observed in 9 patients （10.4%）, and no major complications were noted. There was no significant difference in pre- and post-operative serum creatinine levels. Conclusion Bilateral single-session RIRS is a safe and effective procedure in the treatment of renal stones 〈1.5 cm.
出处
《现代泌尿外科杂志》
CAS
2017年第2期131-133,共3页
Journal of Modern Urology
关键词
输尿管软镜碎石术
同期
双肾结石
retrograde intrarenal surgery
single-session
bilateral renal stones
