组合式输尿管软镜钬激光碎石术治疗肾结石47例  

Modular flexible ureteroscopy combined with holmium laser lithotripsy for treatment of renal calculi: report of 47 cases

作　　者：陈文彬[1] 崔书平[1] 孟宪涛[1] 刘飞[1] 刘英祥 曾博文[1] 王军浩[1] 

机构地区：[1]解放军第260医院泌尿外科,河北石家庄050041 [2]河北省乐亭县卫协医院五官科,河北乐亭063600

出　　处：《临床军医杂志》2015年第3期259-262,共4页Clinical Journal of Medical Officers

摘　　要：目的评价组合式输尿管软镜钬激光碎石术治疗肾结石的临床效果。方法回顾分析我院2012年11月—2013年5月采用组合式输尿管软镜钬激光碎石术治疗肾结石患者47例。结石位于肾中、上盏8例,肾下盏16例,肾盂20例,多肾盏结石3例。结石直径5.0-30.0（16.0±4.0）mm。硬膜外麻醉下,探及结石后使用200μm光纤,0.8-1.0 J/15-20Hz（12-20 W）功率钬激光将结石击碎。术后常规留置5-6 F双J管。术后3 d内尿路平片（KUB）评价碎石效果;术后4周B超或KUB评价结石排净率。结果本组47例中,结石探及率91.5%（43/47）;单次碎石成功率93.2%（41/44）;手术时间65-155（125±16）min。结论组合式输尿管软镜钬激光碎石术治疗肾结石疗效确切、并发症少,是一种安全、有效的方法。Objective To evaluate the clinical effect of modular flexible ureteroscopy combined with holmium laser lithotripsy for treatment of renal calculi. Methods A total of 47 patients with renal calculi were treated with modular flexible ureteroscopy combined with Ho： YAG laser lithotripsy in our hospital from November 2012 to May 2013. There were 8 cases with stones in middle and upper calyx,16 cases in lower calyx,20 cases in renal pelvic and 3 cases in multiple calyxes. The calculi diameter ranged from 5. 0 to 30. 0（ 16. 0 ± 4. 0） mm. Flexible ureteroseopy was used to find renal calculus under epidural anesthesia. The stones were fragmentized and removed by using 200 μm Ho： YAG laser fiber,and holmium laser lithotripsy was used at a maximum energy of 0. 8- 1. 0 J（ 15- 20 Hz /12- 20 W）. F5 or F6 double-J tube was postoperatively indwelled routinely. Examination was done with kidney and upper bladder（ KUB） radiography within 3 days after operation,and re-examination with B-ultrasonography or KUB in 4 weeks after operation for the evaluation. Results The rate of stone detection was 91. 5%（ 43 /47） and the success rate of lithotripsy was 93. 2%（ 41 /44） after one operation. The operation time was 65- 155（ 125 ± 16） min. Conclusion Modular flexible ureteroscopy combined with holmium laser lithotripsy has high efficiency and low complication rate,and is an effective and safe treatment for treatment of renal calculi.

关 键 词：组合式输尿管软镜 肾结石 钬激光 

分 类 号：R692.4[医药卫生—泌尿科学]