经皮肾镜钬激光治疗肾结石68例临床分析  

Percutaneous holmium laser nephrolithotomy for renal calculi

作　　者：任晓[1] 张志国[1] 李龙[1] 汤华章[1] 

机构地区：[1]湖南省浏阳市人民医院泌尿外科,湖南浏阳410300

出　　处：《中国内镜杂志》2010年第1期67-68,共2页China Journal of Endoscopy

摘　　要：目的探讨经皮肾镜钬激光治疗肾结石的疗效及安全性。方法回顾分析该院行经皮肾镜钬激光治疗的68例肾结石患者的临床资料。结果68例均1次穿刺成功,其中49例一期手术清石完全,一期结石清除率72.06%(49/68);19例行二期手术,二期结石清除率为82.35%(56/68)。12例残余结石患者中7例因残余结石暂时不影响肾功能而动态观察,5例患者给予ESWL术,均将残余结石粉碎排净。1例术后输血600mL,无其他严重并发症发生。结论经皮肾镜钬激光治疗肾结石具有安全、高效、便于操作、结石清除率高的特点,值得临床推广。[Objective] To explore the feasibility of B-ultrasound guided ureteroscopie hohnium laser nephrolithotomy via percutaneous nephrostomy for the treatment of complex renal calculi. [Methods] A total of 68 cases of complex renal calculi was included in the study. Under B-ultrasound guidance, a percutaneous nephrostomy was performed untill a F16 catheter could be introduced, with the sheath indwelling in the tract. Then under a F8/ 9.8 ureteroscopy, holmium laser nephrolithotomy was conducted. [ Results ] The renal puncture was successfully ac- comp lished in all the cases. The stone-free rate was 72.06% （49/68） at first stage, and 82.35% （56/68） at second stage. No serious hemorrhage or infection happened. No conversion to open surgery was required. Blood transfusion was needed in 1 case. All opreration were successful and no severity complications were noted in all patients. [Conclusions] Under B-ultrasound guidance, ureteroscopic holmium laser nephrolithotomy via percutaneous nephrostomy for the treatment of complex renal calculi is safe, effective, and feasible.

关 键 词：肾结石 经皮肾镜 

分 类 号：R691.4[医药卫生—泌尿科学]