输尿管软镜下钬激光碎石术治疗肾盏内小结石  

Flexible Ureteroscopy Combined with Holmium Laser Lithotripsy for Small Renal Calix Calculi

作　　者：王彭[1] 于江[1] 尉春晓[1] 曲华伟[1] 陈修德[1] 张建军[1] 

机构地区：[1]山东大学附属省立医院泌尿微创中心,山东济南250021

出　　处：《泌尿外科杂志（电子版）》2013年第4期22-24,共3页Journal of Urology for Clinicians(Electronic Version)

摘　　要：目的评价输尿管软镜联合钬激光治疗肾盏内小结石的效果。方法 2011年5月至2013年1月21例输尿管软镜钬激光碎石病例。术前均行逆行造影检查,明确输尿管及集合系统解剖位置正常。共52枚结石,结石直径0.5~1.5 cm。探查输尿管口置入斑马导丝,导丝引导下置入F12输尿管软镜鞘,经鞘置入日本Olympus URF-V输尿管软镜,抵达目标肾盏行钬激光碎石。留置5F双J管一根4周。结果 2例无法置入输尿管软镜鞘,斑马导丝引导下置入输尿管软镜。钬激光碎石成功率100.0%(21/21)。4周后结石清除率为95.2%(20/21)。总的结石清除率为100.0%(81/86)。平均手术时间为42分钟(18~65分钟)。术后平均住院时间3.8天(3~5天)。无严重并发症。结论输尿管软镜钬激光碎石治疗1.5 cm以下肾多发结石安全有效。其结石排净率高、并发症少,创伤小、住院时间短。可以作为肾多发小结石的首选治疗方式。Objective To evaluate the efficacy of the flexible ureteroscopy with Holmium laser lithotripsy for renal calculi.Methods From May 2011 to Jan 2013, 21 cases of renal calculi(sized between 0.5 to 1.5cm in diameter , 72 calculi in total ) were treated by flexible ureteroscopy with Holmium laser lithotripsy in our hospi-tal.Observe the ureteric orifice and then a ureteric access sheath was placed and a Olympus URF -V flexible ureteroscopy with Holmium laser lithotripsy was used to perform the procedure , and a F5 double-J stent would be setup at the end of procedure for 4 weeks.Result In 2 cases the ureteric access sheath was failed to be placed.20 cases out of 21 (95.2%) had stone clearance at 4 weeks post primary operation , and the total stone clearance rate was 100% ( 21/21 ) .The average operation time was 42 minutes ( 18 ~65 mins ) .No serious complication occurred .Conclusion Flexible ureteroscopy combined holmium laser lithotripsy is a safe and effec-tive procedure for renal calculi , it has high clearance rate of stones and less complication and morbidity , it is the best option for managing small renal calculi .

关 键 词：输尿管软镜 钬激光 碎石 结石 

分 类 号：R699[医药卫生—泌尿科学]