摘要
目的探讨输尿管软镜钬激光碎石术治疗经皮肾镜取石术术后残留结石的安全性、有效性及应用价值。方法回顾性分析2011年1月至2012年9月我院输尿管软镜钬激光碎石治疗22例PCNL术后残留结石患者的资料。PCNL术后残留结石发生于右肾10例,左肾12例,残留结石位于上盏5例、中盏3例、下盏14例,结石直径10.6～18.5mm,平均(14.9±4.8)mm。结果本组21例均顺利置入输尿管软镜,1例因输尿管扩张鞘无法留置,给予留置双J管一周后,二期顺利置入输尿管软镜。22例均顺利寻及结石,19例(86.4%)一次性碎石成功。手术时间40～120min,平均(70±21)min,术后住院3～7d,平均(4±2.5)d。无大出血、输尿管黏膜撕脱、输尿管穿孔等手术并发症发生。拔除双J管后1个月复查KUB及超声,2例结石残留,直径分别是4.6mm和5mm,均位于肾下盏。结论输尿管软镜钬激光碎石治疗PCNL术后残留结石安全、有效。
Objective To evaluate the efficiency and clinical value of flexible ureteroscopic lithotripsy with holmium laser for residual renal stones after PCNL. Methods The data of 22 patients underwent flexible ureteroscopic lithotripsy with holmium laser for esidual renal stones after PCNL from January 2011 to September 2012 were retrospectively reviewed, including 10 cases with right renal stones and 12 cases with left renal stones, 5 cases with upper calyceal stones, 3 cases with middle calyceal stones and 14 cases with lower calyceal stones. The residual stone diameter ranged from 10.6 mm to 18.5 mm, and 14.9±4.8 mm in average. Results Flexible ureteroscopy was successfully placed in 21 patients except one case who was performed with a second-phase flexible ureteroscopy successfully after indwellment of double J stent for a week for ureter distention. Stones were removed in 19 cases （86.4%）. The operative time and hospital stay were 40-120 min （70±21 min in average） and 3-7 d（4±2.5 d in average） respectively. No severe operation associated complication occurred. Two cases of residual lower calyceal stone （4.6 mm and 5 mm） were found by KUB or ultrasonography one month after removing double J stent. Conclusions Flexible ureteroseopic lithotripsy with holmium laser for residual renal stones after PCNL is safe and effective.
出处
《中华腔镜泌尿外科杂志（电子版）》
2013年第3期49-51,共3页
Chinese Journal of Endourology(Electronic Edition)
