软性输尿管镜钬激光碎石术治疗孤立肾结石29例报告  

Flexible ureteroscopy holmium laser lithotripsy in the treatment of solitary kidney stones: Report of 29 cases

作　　者：龙大治 邹晓峰[2] 王晓宁[2] 温晓飞 温机灵 文中华[3] 熊思清[3] LONG Da-zhi;ZOU Xiao-feng;WANG Xiao-ning;WEN Xiao-fei;WEN Ji-lin;WEN Zhong-hua;XIONG Si-qing(Department of Ji'an Hospital Urology,Affiliated Shanghai Oriental Hospital,Ji'an,Jiangxi 343000;Department of Urology,the Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000;Department of Urology,Ji'an People's Hospital,Ji'an,Jiangxi 343000)

机构地区：[1]上海东方医院吉安医院泌尿外科,江西吉安343000 [2]赣南医学院第一附属医院泌尿外科,江西赣州341000 [3]吉安市中心人民医院泌尿外科,江西吉安343000

出　　处：《赣南医学院学报》2019年第2期132-134,共3页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省卫生计划生育委员会普通科技计划项目(编号20175367)

摘　　要：目的:探讨软性输尿管镜钬激光碎石术治疗孤立肾结石的安全性及有效性。方法:回顾性分析2015年1月至2018年1月采用软性输尿管镜钬激光碎石术治疗的29例孤立肾结石患者资料。左侧孤立肾18例,右侧孤立肾11例。结石直径0.9～2.6 cm,平均1.6 cm。单发结石8例,多发结石21例。结果:29例均顺利进镜并完成钬激光碎石术,一次进镜成功率100%。手术时间25～90 min,平均48 min;术中出血量10～40 mL,平均20 mL;住院日3～8天,平均4.5天;2～4周拔除双J管。术后2例患者出现寒战、高热,经积极抗感染治疗后痊愈。其余未见严重并发症。25例行一次手术,4例行两次手术。术后1个月复查,结石总清除率96.55%(28/29)。结论:软性输尿管镜下钬激光碎石术治疗孤立肾结石安全、有效,具有创伤小、出血少、并发症少、术后恢复快等优点,对于合适病例和有经验的医师,FURL可成为孤立肾结石的一线治疗选择。Objective:To investigate the safety and efficacy of flexible ureteroscopy holmium laser lithotripsy in the treatment of solitary kidney stones.Methods:Between January 2015 and January 2018,Clinical data of 29 cases of solitary kidney stones undergone flexible ureteroscopy holmium laser lithotripsy were retrospectively reviewed.18 were on the left side while 11 were on the right.The mean size of the stones was 1.6(0.9-2.6)cm.There were 8 cases of single stone and 21 cases of multiple stones.Results:The flexible ureteroscopy holmium laser lithotripsy was successfully completed in all the 29 patients.The operation time among all cases was 48(mean 25-90)min,the amount of bleeding during surgery was 10-40(mean 20)mL,duration of hospitalization was 3-8(mean 4.5)days.Ureteral stents were remained for an average time of 2-4 weeks after surgery.2 patients developed chills and high fever after operation and these patients recovered after active anti infection treatment.No postoperative serious complications were found among the other patients.25 patients had one operation and 4 patients had a second flexible ureteroscopy operation.The total stone free rate was 96.55%(28/29).Conclusions:Flexible ureteroscopy holmium laser lithotripsy is a safe and effective method for the treatment of solitary kidney stones with advantages of less trauma,less bleeding,fewer complications,and faster postoperative recovery.For the appropriate cases and experienced physicians,it can be the first line treatment choice for the solitary kidney stones.

关 键 词：软性输尿管镜 钬激光 孤立肾 肾结石 

分 类 号：R692.4[医药卫生—泌尿科学]