摘要
目的：探讨微创经皮肾穿刺钬激光碎石治疗上尿路结石的有效性和安全性。方法：患侧输尿管置入输尿管导管，B超引导下建立经皮。肾通道，输尿管镜直视下置入钬激光光纤将结石粉碎，利用灌洗泵将碎石冲出体外。结果：微创经皮肾穿刺钬激光碎石成功率为82．8％（96／116），手术时间45—190min，平均95min。20例肾盏内残余结石（〉4mm），其中8例行二次碎石，其他行体外冲击波碎石及口服排石药。治疗成功率为92．2％（107／116）。术后住院4—16d，平均7．5d。术后高热5例，无严重出血。80例随访3—18个月，平均8．5个月，术后残余结石均排净，肾积水均较术前明显改善。结论：超声引导下微通道或标准通道经皮肾穿刺钬激光碎石是治疗上尿路结石的一种简便、安全、有效的方法。
Objective To evaluate the efficaey and safety of minimally invasive pereutaneous nephrolithotomy （MPCNL） with holmium ： YAG laser for upper urinary tract stone. Method A total of 87 patients with upper urinary tract stone were treated by MPCNL with hol- mium ： YAG laser under the guidance of B - uhrasonography in our hospital. After retrograde placement of the ureteral catheter, atrack from the skin surface into the renal calyx was established, and the Na holmium laser lithotripter was introduced into the urinary tract under a ureteroscope. The stones were broken into pieces and removed. Results The success rate of the operation was 82. 8% （96/116） ,and the mean operation time was 95 min （ranged from 45 to 190 min）. Nine patients had residual stones（ 〉4 mm） in the kidney,and were then treated by ESWL combined with oral dissolution agents. The currate of this series was 92. 2% （ 107/116 ）. The patients were discharged from the hospital 4 to 16 days （ mean 7. 5 days）. For 80 patients were followed up for 3 to 18 months （ mean 8.5 months） ,none of them had residual stones during this period. The symptoms of hydronephrosis was improved in all of the cases. Conclusion B - uhrasonography guided MPC- NL with holmium： YAG laser is convenient, safe, and effective for upper urinary tract stone.
出处
《吉林医学》
CAS
2011年第4期644-646,共3页
Jilin Medical Journal
关键词
超声引导
微创经皮肾穿刺取石术
钬激光
上尿路结石
B - uhrasonography guided
Minimally invasive percutaneous nephrolithotomy
Holmiumlaser
Upper urinary tract stones
