输尿管软镜钬激光碎石术在孤立肾合并肾结石患者中的应用:单中心107例报告  

Flexible ureteroscopic lithotripsy with holmium laser in the treatment of renal stone for patients with solitary kidney:a single center report of 107 cases

作　　者：彭泳涵[1] 施晓磊[1] 刘敏[1] 李凌[1] 王则宇[1] 明少雄 方梓宇 高小峰[1] PENG Yonghan;SHI Xiaolei;LIU Min;LI Ling;WANG Zeyu;MING Shaoxiong;FANG Ziyu;GAO Xiaofeng(Department of Urology,Changhai Hospital,Second Military Medical University,Shanghai,200433,Chin)

机构地区：[1]第二军医大学长海医院泌尿外科,上海200433

出　　处：《临床泌尿外科杂志》2018年第7期516-519,共4页Journal of Clinical Urology

基　　金：上海市科学技术委员会科研计划项目(编号13DZ1941205)

摘　　要：目的:评价输尿管软镜钬激光碎石术治疗孤立肾肾结石的有效性和安全性。方法:回顾性收集2010年1月~2017年10月在上海长海医院接受输尿管软镜碎石手术的孤立肾合并肾结石患者的病例资料,统计分析手术相关的临床资料。结果:研究共纳入107例孤立肾患者,其中男68例,女39例,平均年龄为(52.23±11.47)岁;结石直径为5~68mm,平均(26.56±14.59)mm。初始结石清除率方面,结石直径<20 mm高于结石直径>20mm的患者(63.89%vs.40.85%,P<0.05);多次手术后,两组最终结石清除率差异无统计学意义(94.44%vs.85.92%,P>0.05)。结石直径<20 mm的患者,平均行1.33(1~3)次手术;而结石直径>20 mm的患者,平均行1.85(1~6)次手术,两组比较差异有统计学意义(P<0.05)。手术相关并发症发生率为19.63%,99.07%为ClavienⅠ~Ⅱ级。结论:输尿管软镜治疗孤立肾肾结石安全、有效,对于结石体积较大的患者,采用分次手术可达到较好的清石效果。Objective：To discuss the safety and efficacy of flexible ureteroscopic lithotripsy（f-URL）in the treatment of renal stone for patients with solitary kidney.Method：Patients＇ materials were retrospectively retrieved,who underwent f-URL in Shanghai Changhai Hospital from Jan.2010 to Oct.2017 for solitary kidney stone,and surgery related clinical data were statistically analyzed.Result：A total of 107 solitary kidney patients were enrolled,including 68 males and 39 females,whose mean age was（52.23±11.47）years old and mean stone diameter was（26.56±14.59）mm（range,5-68 mm）.Initial stone free rate（SFR）of patients with stone20 mm was higher than those with stone20 mm.After multiple staged operations,final SFR of both groups showed no statistical significance（94.44% vs.85.92%,P=0.330）.For patients with stone20 mm,mean times of staged operation were 1.33（range,1-3）to achieve stone free status,while for patients with stone20 mm,those were1.85（range,1-6）.There existed statistical significance（P=0.005）.Complication occurrence was 19.63%,of which 99.07% were Clavien Ⅰ-Ⅱ grade.Conclusion：For solitary kidney stone patients f-URL is effective and safe,and multiple stages of surgeries are needed to achieve better SFR for large stones.

关 键 词：输尿管软镜 钬激光碎石 肾结石 孤立肾 

分 类 号：R692.4[医药卫生—泌尿科学]