微造瘘经皮肾镜钬激光碎石术治疗肾结石103例  

Micro-fistula Percutaneous Nephrolithotomy Holmium Laser Lithotripsy Treatment of 103 Cases of Kidney Stones

作　　者：王庆军[1] 吕民[1] 王海[1] 

机构地区：[1]江苏省新沂市铁路医院泌尿外科,新沂221400

出　　处：《中国医药导刊》2010年第1期16-18,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨微造瘘经皮肾镜钬激光碎石术治疗肾结石的临床效果及并发症的防治措施。方法:彩超定位穿刺下,经皮微造瘘,采用狼牌(WOLF)8/9.8 F输尿管硬镜,应用钬激光碎石机,功率设置在(12～20)W,进行碎石并联合取石钳取石。结果:本组103例,均穿刺成功.单通道碎石取石97例,双通道取石6例。全部病例主要结石均被取出,单纯肾盂或肾盏结石取净率为96%,多发、铸型或鹿角型结石取净率为67%。手术时间一般为(90～150)min,特殊1例7小时,术中明显渗血5例,手术结束时严重大出血1例,改开放手术,切除患肾,无周围脏器损伤及死亡病例。术后住院时间为(7～15)d。术后无行体外震波碎石病例。随访全部病例2～6个月,血尿、尿频、尿痛及腰部疼痛症状均消失,无结石复发。结论:微造瘘经皮肾镜钬激光碎石术是在传统经皮肾镜取石术基础上改进的新技术,具有创伤小、并发症少、恢复快、一次清除结石率高、疗效确切等优点,值得临床推广使用。Objective： To explore the micro-fistula percutaneous nephrolithotomy holmium laser lithotripsy treatment of kidney stones and complications of the clinical effect of control measures. Methods： Color Doppler positioning under the puncture, percutaneous micro- ostomy, using WOLI~ （WOLF） 8 9,8 F rigid ureteroscope, holmium laser lithotripsy applications, the power set （12 ~ 20） W, for gravel and jointly take stone pliers take stone. Results： 103 cases in this group are puncture success. Toishi 97 cases of single-channel gravel, dual-channel take stones in 6 cases. All cases are mainly stone were removed, simple renal pelvis or calyceal stones to take the net rate of 96%. multiple, mold. or staghorn stones to take the net rate of type 67%. Operative time was generally （90 - 150） rain, a special one cases of 7 hours, intraoperative bleeding is evident in 5 cases, the end of surgery severe bleeding in 1 case. changed open surgery, removal of suffering from kidney, without the surrounding organ injury and death cases. Postoperative length of stay （7 - 15） d. After non-row cases of extracorporeal shock wave lithotripsy. All patients were followed up for 2 to 6 months, hematuria, urinary frequency, dysuria, and lower back pain disappeared, no stone recurrence. Conclusion： Micro-fistula percutaneous nephrolithotomy holmium laser lithotripsy in the traditional percutaneous nephrolithotomy lithotomy based on the new and improved technologies, with tess trauma, less complications and quicker recovery, a high rate of stune clearance, efficacy and so the exact advantages, it is worth for clinical use.

关 键 词：微造瘘 经皮 肾镜 钬激光碎石 肾结石 

分 类 号：R699[医药卫生—泌尿科学]