大功率钬激光经皮肾微造瘘输尿管镜治疗复杂性肾结石(附65例报告)  

High-power Holmium Laser with Mini-Percutaneous Nephrolithotomy for Complex Kidney Calculi(Report of 65 Cases)

作　　者：余兆雄[1] 杨荣权[1] 蔡勇[1] 廖泽明[1] 王超[1] 李壮志[1] 

机构地区：[1]荆门市第一人民医院泌尿外科,湖北荆门448000

出　　处：《临床泌尿外科杂志》2009年第10期766-767,770,共3页Journal of Clinical Urology

摘　　要：目的:探讨大功率钬激光经皮肾输尿管镜治疗复杂性肾结石的方法与效果。方法:应用大功率(60W,3.0 J,20 Hz)钬激光经皮肾输尿管镜治疗复杂性肾结石65例,其中多发性肾盂肾盏结石48例(平均直径3.1cm),鹿角状结石17例(平均直径5.3 cm),统计大功率钬激光碎石术碎石时间、结石取净率以及手术并发症等。结果:平均每次手术碎石取石时间为65(36～128)min,一次治疗结石取净率为69%(45/65),总的取净率为91%(59/65),术后5例出现发热,6例结合ESWL排净,3例有少量残留结石,1例术后出血较多行超选择性动脉栓塞后治愈,无其他并发症。结论:大功率钬激光经皮肾输尿管镜治疗复杂性肾结石能快速粉碎结石,缩短手术时间,出血量少,效率高,是治疗结石的安全、有效方法。Objective：To assess the feasibility and efficacy of the high-power holmium laser with mini-percutaneous nephrolithotomy for complex kidney calculi. Methods： 65 patients with complex kidney calculi were treated with the high-power（60 W： 3.0 J × 20 Hz）holmium laser with mini-percutaneous nephrolithotomy. There were 48 renal units with multi-kidney pelvic and calyceal calculi（average diameter 3. 1 cm）, 17 renal units with staghom calculi（average diameter 5.3 cm）. The duration of stone surgery, stone-free rate and complication were assessed. Resuits：The mean duration of stone surgery was 85min（56 178min）, the stone-free rate was 69 % （45/65）after the first session, 91%（59/65） at the end of session. 5 cases had high fever after surgery, 6 cases were completely cleared combined with extracorporeal shock wave lithotripsy（ESWL）, 3 cases still had small amount of residues, 1 case complicated with severe bleeding after operation were successfully treated with super-selective arterial embolization, no other adverse events were noted. Conclusions： The high power holmium laser with mini-percutaneous nephrolithotomy can fragments calculi quickly and reduces the length of time of operation, efficient technique and less trauma. It is an effective and safe technique for complex kidney calculi.

关 键 词：钬激光 经皮肾微造瘘 输尿管镜 肾结石 

分 类 号：R692.4[医药卫生—泌尿科学]