微创经皮肾镜钬激光碎石术治疗复杂性肾结石的临床研究  

Clinical study of minimally invasive percutaneous nephroscopic holmium laser lithotripsy in treatment of complicated renal calculi

作　　者：李小滨[1] 刘跃江[1] 陈荣[1] 李家泉[1] 刘平[1] 

机构地区：[1]自贡市第一人民医院泌尿外科,四川自贡643000

出　　处：《现代医药卫生》2013年第5期703-704,707,共3页Journal of Modern Medicine & Health

摘　　要：目的探讨微创经皮肾镜钬激光碎石术治疗复杂性肾结石的临床疗效及手术安全性。方法回顾性分析2008年1月至2012年8月采用微创经皮肾镜钬激光碎石术治疗复杂性肾结石98例患者的临床资料,观察治疗效果并进行分析总结。结果 98例患者中行一期手术者89例,行二期手术者9例;一期手术取尽结石79例,二期手术取尽结石6例,总结石取净率为86.7%(85/98);处理结石的平均时间(60±20)min,平均出血110 mL,术中均不需输血。术后1例患者发生继发性出血,经选择性肾动脉栓塞后止血,未出现液气胸、尿瘘、腹腔脏器损伤、感染性休克等并发症。结论微创经皮肾镜钬激光碎石术治疗复杂性肾结石疗效确切、安全可靠、术后并发症发生率低、恢复快、结石清除率高,值得临床推广应用。Objective To investigate the clinical efficacy and surgical safety of minimally invasive percutaneous nephro- scopic holmium laser lithotripsy in the treatment of complicated renal calculi. Methods The clinical data of 98 patients with complicated renal calculi treated by minimally invasive percutaneous nephroscopic holmium laser lithotripsy in this hospital from January 2008 to August 2012 were analyzed retrospectively. Results One-stage operation was done in 89 cases and two-stage operation was done in 9 cases. Calculi was completely removed in 79 case of one-stage operation and 6 cases of two-stage operation with the total calculi clearance rate of 86.7% （85/98）. The average processing time was （60~20）min, the average hemorrhage volume was 110 mL without intraoperative blood transfusion. Secondary bleeding occurred in 1 case after operation and stopped after renal artery embolization wihout complications like liquid pneumothorax,urinary fistula,abdominal organ injuries,septic shock and so on. Conclusion Minimally invasive percutaneous nephroscopic holmium laser lithotripsy in the treatment of complicated renal calculi is effective, safe and reliable with low incidence of postoperative complications, faster recovery and high stone clearance rate, and worthy of clinical application.

关 键 词：肾结石 外科学 肾造口术 经皮 碎石术 激光 方法 钬 治疗应用 内窥镜检查 

分 类 号：R699.1[医药卫生—泌尿科学]