输尿管软镜碎石取石术治疗2cm以上肾结石的临床观察  

Flexible Ureteroscope with Holmium Laser Lithotripsy for Renal Stones of More Than 2 cm in Diameter

作　　者：张林[1] 刘同族[1] 王行环[1] 王永志[1] 杨志伟[1] 

机构地区：[1]武汉大学中南医院泌尿外科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2017年第5期812-814,共3页Medical Journal of Wuhan University

基　　金：湖北省自然科学基金资助项目(编号:2014CFB203)

摘　　要：目的:探讨输尿管软镜碎石取石术治疗2cm以上肾结石的有效性和安全性。方法:2cm以上肾结石患者,输尿管软镜钬激光碎石取石术共53例,预置输尿管支架管2周后均采用输尿管软镜钬激光碎石取石术治疗,术后1月行腹部平片复查,若必要则行再次手术。结果:所有患者均无脓毒血症、肾功能不全、大出血等严重并发症,术后发热的发生率为15.1%,术后肾绞痛的发生率为7.5%。首次手术结石清除率为81.1%,总体结石清除率为96.2%。平均手术次数为1.2次(1-2次)。结论:输尿管软镜碎石取石术治疗2cm以上肾结石安全、结石清除率高,可作为推荐治疗方案。Objective：To evaluate the safety and efficacy of flexible ureteroscopic lithotripsy for renal stones of more than 2cm.Methods：53cases of renal calculi more than 2cm treated by flexible ureteroscopy with holmium laser lithotripsy in our department were retrospectively analyzed.X ray or CT examination had been performed pre and post operation（one month after）to assess the stone excretion rate.D-J stent was placed for every case at least two weeks pre-operation.Results：No severe complications such as sepsis,renal insufficiency,and massive haemorrhage were found.The primary stone-free rate was 81.1%（43cases）.The overall stone excretion rate was 96.2%（51cases）.Post-operation fever occurred in 8cases,and 4cases showed post-operation renal colic.Conclusion：Flexible ureteroscopy with holmium laser lithotripsy showed considerable efficacy and good safety,which could be recommended as a viable operation option for renal calculi more than 2cm.

关 键 词：肾结石 输尿管软镜 钬激光 

分 类 号：R693.4[医药卫生—泌尿科学]