摘要
目的评价输尿管软镜下钬激光碎石术处理直径〉2 cm肾和输尿管上段结石的可行性和安全性。方法采用输尿管软镜下钬激光碎石术治疗直径〉2 cm肾和输尿管上段结石79例,其中结石直径2-3 cm者70例,3-4 cm者5例;鹿角形结石4例;多发结石38例,单发结石41例。术前2周留置双J管扩张输尿管,2周后行输尿管软镜下钬激光碎石取石术。结果 79例均成功入镜并碎石取石。2周后随访结石一次性清除率为78.48%（62/79）,2次手术7例,3次手术1例,4次手术2例,平均手术次数1.2（1-4）次,最终结石清除率为88.61%（70/79）。术后发热4例,输尿管末段结石形成1例,＂石街＂形成2例,经积极处理后均痊愈出院。结论输尿管软镜下钬激光碎石术治疗2-4 cm肾和输尿管上段结石安全、有效,并可作为特殊情况下鹿角形结石的一种治疗手段。
Objective To evaluate the feasibility and safety of flexible ureteroscopic lithotripsy in treatment of intra-renal and proximal ureteral calculi in diameter of 〉 2 cm. Methods A total of 79 patients with intra-renal or proximal ureteral calculi in diameter of 〉 2 cm undergoing flexible ureteroseopic lithotripsy with Holmium laser in our department from November 2013 to January 2015 were enrolled in this study. There were 70 cases with stone size ranging from 2 to 3 cm and 5 cases from 3 to 4 cm ; 4 cases of staghorn calculi ; and 38 cases of multiple stones and 41 cases of single stone. All patients were placed double J stents in 2 weeks before operation, and Holmium laser was used to perform the procedure. Results Ureteroscope was inserted successfully in all the patients, so was lithotripsy. The follow-up in 2 weeks post-operatively showed that the stone-free rate was 78.48% （62/79）. There were 7 cases receiving lithotripsy twice, 1 case for triple times and 2 cases for 4 times, and the mean number of procedures was 1.2 （ranging from 1 to 4 times）. The final overall stone-free rate was 88.61% （70/79）. After operation, 4 cases had fever, 1 had distal ureteral calculi, and 2 had steinstrasse formation. All of them were discharged Conclusion Flexible ureteroscopic lithotripsy with Holmium laser is a safe renal and proximal ureteral calculi in size of 2 to 4 cm, and can be used staghorn calculi. after corresponding treatment. and effective approach for intra- as an alternative option for enal
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2016年第3期302-306,共5页
Journal of Third Military Medical University
关键词
输尿管镜
钬激光
肾结石
输尿管结石
flexible ureteroscopy
Holmium laser
intra-renal calculi
ureteral calculi
