新型组合式输尿管软镜钬激光治疗肾结石的疗效分析

发布时间：2018-02-01 17:16

本文关键词： 肾结石碎石术激光输尿管软镜清石率并发症　出处：《中华临床医师杂志(电子版)》2013年24期 　论文类型：期刊论文

【摘要】：目的探讨新型组合式输尿管软镜钬激光碎石术治疗肾结石的有效性和安全性。方法回顾分析2012年11月至2013年9月收治的48例肾结石患者,采用新型组合式输尿管软镜钬激光碎石术治疗。按不同年龄、结石位置(肾盂、肾上中盏、肾下盏)、结石大小、术前是否行体外冲击波碎石治疗(ESWL)分组,术后清石率以出院前KUB复查结果和出院1个月、2个月后复查KUB或超声结果进行疗效评价。结果术中46例(95.83%)患者成功找到并粉碎结石;术后2例(4.17%)患者出现高热寒战;术后第3天复查KUB清石率为64.58%(31/48),术后1个月复查清石率为85.42%(41/48),按不同年龄、结石位置、结石大小、术前是否行ESWL治疗分组清石率比较差异无统计学意义(P0.05);术后2个月复查清石率93.75%(45/48),因2个月后复查清石率较高各组未进行统计学比较。结论新型组合式输尿管软镜钬激光碎石术治疗肾结石具有清石率高并发症轻、发生率低等优势,值得推广。
[Abstract]:Objective to investigate the efficacy and safety of new combined ureteral soft endoscopy holmium: YAG laser lithotripsy in the treatment of renal calculi. Methods 48 patients with renal calculi from November 2012 to September 2013 were retrospectively analyzed. A new type of combined ureteroscopic holmium: YAG laser lithotripsy was used. According to the age, the stone location (pelvis, upper middle calyx, lower calyceal, stone size) was used. Whether ESWL was treated with ESWL before operation was divided into two groups. The rate of lithotripsy after operation was determined by KUB before discharge and 1 month after discharge. After 2 months, the curative effect was evaluated by KUB or ultrasound. Results 46 cases (95. 83%) were successfully found and crushed during the operation. There were 2 patients with high fever and shivering after operation. The stone removal rate of KUB was 64.58 / 41 / 48 on the third day after operation, and 85.42 / 41 / 48 on the first month after operation, according to the age, location and size of the stone. There was no significant difference in stone clearance rate between groups with ESWL before operation (P 0.05). The lithotomy rate was 93.75% 45 / 48 2 months after operation. Conclusion the new combined ureteroscopic holmium: YAG laser lithotripsy has the advantages of low complication and low rate of stone removal, and is worth popularizing.
【作者单位】：山西医科大学研究生学院;山西医学科学院山西大医院泌尿外科;
【分类号】：R699
【正文快照】： 上尿路结石,常可因反复感染、梗阻进而肾积水导致肾功能受损,严重者可危及生命。上尿路结石的治疗包括开放手术切开取石、体外冲击波碎石治疗(extracorporeal shock wave lithotripsy,ESWL)、后腹腔镜切开取石、经皮肾镜碎石取石、输尿管硬镜碎石、输尿管软镜碎石等方法,随着

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