摘要
目的 :探讨输尿管软镜下钬激光碎石术治疗肾盏结石的疗效。方法 :采用输尿管软镜下钬激光碎石术治疗肾盏结石 78例 ,结石大小 0 .8～ 1.8cm ,平均 1.1cm。经留置输尿管扩张鞘或沿导丝直接置入F7.9输尿管软镜抵达肾盂 ,寻及结石后以 2 0 0 μm光纤、10W功率钬激光碎石。 结果 :78例共有结石 81枚 ,其中上、中盏结石 5 3枚 ,结石寻及率 10 0 % ,单次碎石成功率 96 .2 % (5 1/ 5 3) ;下盏结石 2 8枚 ,结石寻及率 96 .4 % (2 7/ 2 8) ,单次碎石成功率 71.4 % (2 0 / 2 8)。无严重并发症发生。结论 :输尿管软镜下钬激光碎石术治疗肾盏结石安全、有效 ,尤其适用于结石体积较小、肾盏无明显积水 ,以及因解剖特点预期体外冲击波碎石效果不佳的患者。通过软镜能寻及绝大多数肾盏结石 ,中、上盏结石单次碎石成功率高于下盏结石 。
Objective:To evaluate the therapeutic effect of Ho:YAG laser lithotripsy with flexible ureteroscope on the treatment of calyceal calculi.Method:78 cases of calyceal calculi were treated with VersaPulse Select Ho:YAG laser lithotripter through flexible ureteroscope. The calculi ranged from 0.8 to 1.8 cm (mean 1.1 cm). F7.9 flexible ureteroscope was used during the procedure with or without the placement of a ureteral access sheath. The laser was used at a maximum energy of 10w (1 J/pulse at 10 Hz).Result:78 cases had 81 stones in calyx. All of the 53 stones in upper or middle calyx had been found, and the successful fragmentation rate in one single session was 96.2%(51/53). The stone access rate of the 28 stone in lower calyx was 96.4%(27/28), and the fragmentation rate in one session was 71.4%(20/28). No major complications were observed.Conclusion:Holmium laser lithotripsy with flexible ureteroscope is a powerful, effective, and safe treatment modality for calyceal calculi, especially for those with unfavorable anatomic factors related to ESWL and those with diameter<2 cm and without significant hydronephrosis. The low successful fragmentation rate for the lower calyceal calculi is associated with the decreasing of flexibility after the laser fiber passed via the ureteroscope.
出处
《临床泌尿外科杂志》
2004年第3期139-141,T002,共4页
Journal of Clinical Urology
关键词
肾盏结石
输尿管软镜
钬激光
Calyceal calculi
Flexible ureteroscope
Holmium laser
