微创经皮肾镜钬激光碎石术治疗肾结石  

Minimally invasive percutaneous nephrolithotomy with holmium laser for the treatment of renal calculi

作　　者：薛书成[1] 武艺[1] 裴昌松[1] 李克[1] 王玉林[1] 

机构地区：[1]江苏省徐州医学院第二附属医院泌尿外科,221006

出　　处：《中国实用医药》2008年第35期28-30,共3页China Practical Medicine

摘　　要：目的探讨微创经皮肾镜钬激光碎石术治疗肾结石的安全性及疗效。方法患侧输尿管内置入F6输尿管导管,B超定位下选择中肾盏后组穿刺造瘘,建立F16经皮肾通道,输尿管肾镜直视下置入钬激光光纤将结石粉碎,利用灌洗压力将碎石颗粒冲出。结果手术时间90～240min,平均手术时间120min。结石清除率为86.87%(86/99)。13例术后残石患者行ESWL治疗。术后无继发性出血。术后住院时间4～12d,平均6.6d。随访全部病例2～6个月,腰部疼痛、血尿等症状均消失,无结石复发。结论微创经皮肾镜钬激光碎石术具有创伤小、出血少、并发症少、恢复快等优点且治疗效果令人满意,是治疗肾结石安全有效的方法。Objective To explore the safety and efficiency of minimally invasive percutaneous nephro- lithotomy with holmium laser for the treatment of renal calculi. Methods After retrograde placement of the ureteral catheter（F6）, a track （F16）from the skin surface into the middle renal calyx was established under the guidance of a B-ultrasonography. Then a ureterscope was passed to introduce a holmium laser lithotriptor. Stones were broken up and a nephrostomy tube was placed in the incision to carry fluid from the kidney. Results The duration of operation was 90 - 240 rain （mean, 120 min）. The stone-free rate was 86. 87% （86/99）. 13 cases with residual stone underwent extracorporal shock wave lithotripsy after the operation. No postoperative hemorrhage happened. The length of postoperative hospital stay was 4-12 d （mean,6. 6 d）. Follow-up observations in the 99 cases for 2 -6 months showed complete relief of symptoms and no recurrent stone. Conclusion Holmium laser percutaneous nephrolithotomy is safe and effective in the treatment of renal calculi.

关 键 词：经皮肾镜 钬激光 肾结石 

分 类 号：R699[医药卫生—泌尿科学] R693.4[医药卫生—外科学]