摘要
目的评价输尿管软镜(FURL)联合钬激光碎石术同期治疗双侧上尿路结石患者的安全性和有效性。方法回顾性分析该院2014年9月至2016年11月采用FURL联合钬激光碎石术同期治疗双侧上尿路结石患者43例的临床资料。所有患者术前行CT扫描,术中置入FURL,使用200μm光纤,0.8~1.0J/10~20Hz功率进行碎石,配合使用取石网篮,碎石后常规留置双侧输尿管支架管。术后1d复查KUB或CT,结石残留者4~6周后取出输尿管支架管时再次复查KUB。结果所有患者均一次性成功置入输尿管软镜,平均手术时间(101.5±37.2)min,结石清除率(SFR)为81.4%(35/43)。结石负荷小于30mm清除率为100.0%,与大于或等于30mm(63.2%)比较差异有统计学意义(P<0.05)。术后1例患者出现发热(39.5℃),1例患者出现肾包膜下血肿,无其他严重并发症发生,术后住院时间平均4d。结论 FURL联合钬激光碎石术是同期治疗双侧上尿路结石的有效手段,尤其是对于结石负荷小于30mm者,具有较高的SFR,安全性良好。
Objective To evaluate the effectiveness and safety of flexible ureteroscopy lithotripsy （FURL） combined with holmium laser for the concurrent treatment of bilateral upper ureteral tract calculi. Methods The clinical data in 43 patients with bilateral upper ureteral tract calculi concurrently treated by FURL combined with holmium laser in our hospital from September 2014 to November 2016 were retrospectively analyzed. All cases conducted CT scanning before operation. The flexible ureteroseope was intraoperatively placed and the lithotripsy was conducted by using 200 μm optical fiber at a power of 0.8-1.0 J/10-20Hz, which was coordinated by reticular basket. After lithotripsy,bilateral urethral stents were placed. KUB or CT was re-examined on postoperative 1 d. The eases of residual stone were performed KUB again after removing urethral stent after 4-6 weeks. Results All cases were successfully placed the flexible ureteroscope by one time. The mean operation time was （101.5± 37.2） min and the overall stone-free rate （SFR） was 81.4% （35/43）. SFR was 100% in the patients with the stone burden less than 30 mm and 63. 2% in the patients with the stone burden ≥30 mm, the difference was statistically significant（P〈0.05）. One case appeared fever （39.5 ℃） after operation,1 ease develcped subeapsular renal hematoma and no other severe complications occurred. Conclusion FURL combined with holmium laser is an effective means to concurrently treating bilateral upper ureteral calculi,especially for the patients with stone burden 〈30 ram,which has higher stone clearance rate with good safety.
出处
《重庆医学》
CAS
北大核心
2017年第28期3917-3919,共3页
Chongqing medicine
基金
重庆市自然科学基金资助项目(cstc2011jjA10034)
重庆市医学科研计划重点基金资助项目(2011-1-054)
关键词
输尿管软镜
碎石术
激光
输尿管结石
肾结石
flexible ureteroscopy
lithotripsy,laser
ureteral ealculus
renal calculus
