钬激光在泌尿外科的初步应用探讨(附496例报告)  

The exploration of holmium laser preliminary application in management of urinary disease

作　　者：周正兴[1] 马成民[1] 马克 陈红兵[1] 张超[1] 程小宝[1] 刘骋[1] 李波[1] 程冬[1] 朱敬波[1] 孙建刚[1] 

机构地区：[1]合肥市第一人民医院泌尿外科,230061

出　　处：《安徽医学》2009年第1期31-35,共5页Anhui Medical Journal

摘　　要：目的探讨钬激光治疗泌尿系疾病的有效性和安全性。方法选择我院自2004年3月至2008年6月采用钬激光治疗泌尿系统疾病496例,并对之进行回顾分析。结果152例输尿管结石患者147例单次钬激光碎石成功,5例因输尿管口水肿无法置入输尿管镜术后半月再次行钬激光碎石成功。26例PCN患者,22例一次钬激光碎石彻底,4例因复杂肾结石保留肾造瘘管分次碎石。107例HoLEP术,103例手术一次成功,4例患者因术中类似表现TURS,手术暂停分期进行。70例膀胱肿瘤切除,57例一次成功。对分布广泛的9例多发性膀胱肿瘤采取分期分批切除法。43例尿道狭窄患者,36例随访3个月～3年效果满意。12例UPJ患者10例术后随访5个月～3年效果满意,2例因反复狭窄行开放UPJ肾盂整形。10例输尿管口囊肿均一次手术成功,术后9例获随访3～28个月,临床症状消失。12例尖锐湿疣患者一次性切除,术后配合药物辅助治疗,随访5～28个月无复发。结论钬激光是一种高效、安全、方便而性能稳定的医用激光,具有汽化、切割和凝固的多重特性,钬激光结合日渐成熟的泌尿腔内技术,其在泌尿外科的应用前景广阔。Objective To investigate the efficacy and safety of holmium laser in the treatment of urinary diseases. Methods To select 496 patients who were diagnosed with urinary disease and treated with holmium laser from March 2004 to June 2008 in our hospital. Results Among of 152 patients who suffered from ureteral calculus ,147 patients broken stone by holmium laser at first time,5 patients received lithothrypty successfully after operation 15 days because of ureter edema.Among of 26 patients who underwent PCN,22 cases successfully at first time,4 cases broken stone by holmium laser at different time because of complicated renal calculus.107 patients who received HoLEP,103 cases successfully,4 patients to display TURS during operation,and then stopped operating,to finish at different time.70 cases of bladder tumor,57cases resected successfully at the first time,9 patients who suffered from multiple tumors adopted reseteted by stages and in batch. 43 cases of urethral stricture,36 patients were followed up from 3 months to 3 years,urination were effective .12 cases of UPJ,10 patients were followed up from 5 months to 3 years,the effect was satisfactory.2 patients received opened-operation for stenosis again and again. 10 cases of cyst in ureteric orifice ,were all successfully at the first time.9 patients were followed up from 3 to 28 months,clinical symptom disappeared. 12 cases of eondyloma acuminatum,were all reseeted successfully at the first time,aided with medicine,followed up from 5 to 28 months,no case to recur. Conclusions Holmium laser is a highly effective,safe ,convenient and performance nonactive medical laser,It has vaporization,cutting and solidification multifarious function.Holmium laser deeply, with the urinary intracavitary technique can be used in the treatment of urinary diseases wider and wider.

关 键 词：泌尿系疾病 治疗 钬激光 临床应用 

分 类 号：R699[医药卫生—泌尿科学]