现代腔内新技术在复杂性上尿路结石治疗中的临床应用(附5296例报告)  

Application of New Modern Endoscopic Technology on Treatment of Complicated Upper Urinary Calculi(with 5296-case-report)

作　　者：袁超英[1] 安尼瓦尔.牙生[2] 王砺 

机构地区：[1]武警新疆总队医院泌尿外科 [2]新疆医科大学第一附属医院泌尿外科 [3]新疆生产建设兵团总医院泌尿外科

出　　处：《新疆医学》2011年第7期4-10,共7页Xinjiang Medical Journal

摘　　要：目的:探讨现代腔内新技术治疗复杂性上尿路结石的疗效和安全性。方法:回顾性分析2005年5月～2011年3月三个治疗中心采用多种现代腔内新技术治疗5296例复杂性上尿路结石患者的临床资料,其中应用气压弹道、EMS三代吸附式超声联合气压弹道、钬激光碎石装置行mPCNL3317例和PCNL1490例,共4807例(90.77%),双频双脉冲U-100激光碎石装置行URSL357例(6.74%),腹腔镜下输尿管上段结石取石术76例(1.44%),输尿管软镜下激光碎石56例(1.06%),并对mPCNL和PCNL两组并发症应用SPSS11.0软件进行统计学分析。结果:5296中一次碎石总有效率97.02%,其中1个月后结石净石率mPCNL90.74%、PCNL93.08%、双频双脉冲U-100激光碎石87.96%、输尿管软镜下碎石87.50%、腹腔镜手术取石净石率97.37%。mPCNL和PCNL两组一般并发症分别为:12.03%、18.52%,P>0.05无统计学差异。严重并发症分别为:1.66%、3.56%,P<0.05,有统计学差异。结论:采用现代腔内新技术治疗复杂性上尿路结石具有微创、安全、疗效高、并发症少等优点,mPC-NL和PCNL是其主要治疗方法之一,应首选。mPCNL严重并发症明显低于PCNL。治疗方法的选择应根据治疗单位的设备条件和医生的临床经验和技术水平而定。联合治疗可提高疗效、降低并发症、提高净石率。Objective To study efficacy and safety of complicated upper urinary calculi treated with new endoscopic technology. Methods 5296 complicated upper urinary calculi cases from May 2005 to March 2011 in three treatment centers were retrospective analyzed and modem endoscopic new teehniques were used in the treatment of these cases. New techniques in the treatment of complicated upper urinary calculi were conducted such as ballistie,EMS, three generations pressure adsorption ultrasound joint air pressure, ballistic, Holmium YAG laser, lithotrips laser device in mPCNL for 3317 cases and in PCNL for 1490 eases, with a total of 4807 patients （90.77%） ;Double -frequency excited double pulse U 100 laser device with gravel URS 357 cases （6.74%） ,76 eases（ 1.44% ） ,and retroperitoneal laparoseopic ureterolithotomy, upper ureteral calculi. Statistical analysis was applied . Results In all 5296 cases, the total effective rate of treatment was 97.02%. A month later,the stone clearance rate of each technique was 90.74 % for mPCNL, 93.08 % for PCNL,87. 96% for double y frequency excited double pulse U 100 laser gravel, 87.50% for ureteral soft microscopically gravel,and 97.37% for laparoscopic surgery, respectively. Complications of group in mPCNL and PCNL was 12.03%, 18.52%, respectively. There was no statistically significanees （P 〉 0.05）. Serious complications rate were 1.66% ,3.56% , and there was statistical differences（P 〈0.05）. Conclusion The new techniques for the treatment of modem chamber on complexity upper complicated upper urinary calculi has many advantages such as minimally invasive, safety, high curative effect and less complications. PCNL and mPCNL are the main treat- ment teehniques,whieh should seen as first selection. A mPCNL severe complication was significantly lower than the PCNL. The selection of treatment should be based on the treatment of the unit equipment condition and the doctorg clinical experience and technical level and decide. Combination therapy can increase the curativ

关 键 词：腔内新技术 治疗 复杂性上尿路结石 

分 类 号：R691.4[医药卫生—泌尿科学]