软性输尿管镜钬激光治疗肾盂输尿管连接部结石61例体会  

Flexible ureteroscopic treatment of calculi at ureteropelvic junction with ho ： YAG laser： experience of 61 cases

作　　者：晋连超[1] 潘东亮[1] 张祥华[1] 那彦群[1] 

机构地区：[1]北京大学首钢医院吴阶平泌尿外科医学中心,北京100144

出　　处：《国际泌尿系统杂志》2013年第4期465-468,共4页International Journal of Urology and Nephrology

基　　金：基金项目：中国科学院环境化学与生态毒理学国家重点实验室开放基金（KF2011-12）

摘　　要：目的总结软性输尿管镜钬激光治疗肾盂输尿管连接部结石碎石取石的l临床经验。方法回顾性分析本院2011年10月～2013年1月软性输尿管镜钬激光碎石治疗61例肾盂输尿管连接部结石患者的临床资料，结石直径7～20mm。术前均留置F7BardD—J管1周，术中使用OlympusF7．9输尿管软镜，术后常规留置F7D—J管2～4周。术后1个月、3个月时复查KUB或双肾cT平扫，评估结石排净率。结果本组软性输尿管镜一次性碎石成功率为58／61（95．1％），清石率为57／61（93．4％）。输尿管穿孔3例，中转经皮肾镜碎石取石3例，术后残留结石需震波碎石1例。结论软性输尿管镜钬激光治疗肾盂输尿管连接部结石清石率高，并发症少，可作为治疗。肾盂输尿管连接部结石的首选术式。Objectives To summarize the experiences of treating calculi at ureteropelvic junction with flex- ible ureteroscope and Ho：YAG laser. Methods 61 patients with calculi at ureteropelvic junction （ calculus size from 7mm to 20 mm in diameter） were treated with flexible ureteroscope and Ho： YAG laser in our hospital. The dataof patients were analyzed retrospectively. A F7 double - J stent was inserted into ipsilateral ureter a week before operation. Olympus F7.9 flexible ureteroseope was used during lithotripsy procedure. The double - J stent was re- moved at 2 - 4 weeks postoperatively. A follow - up was done by means of KUB or non - contrast CT scan to evaluate the result of lithotripsy at 1 months and 3 months postoperatively. Results The success rate of flexible uretero- scopic lithotripsy was 58/61 （95.1%） at one time. The clearance rate of calculi was 57/61（93.4% ）. Flexible uret- eroscopic lithotripsy failed in 3 cases and further PCNL lithotripsy performed. Ureteral perforation happened in 3 ca- ses. One case had residual fragments of stone and received ESWL. Conclusions Flexible ureteroseopic treat- ment of calculi at ureteropelvic junction with I-/o：YAG laser showed the feasibility, safety and validity. It may be re- garded as one of the first - choice treatment for treatment of calculi at ureteropelvic junction.

关 键 词：尿路结石 输尿管镜检查 激光 固体 

分 类 号：R699[医药卫生—泌尿科学]