输尿管软镜联合钬激光法治疗肾结石的临床分析

发布时间：2018-04-19 15:42

  本文选题：肾结石 + 电子输尿管软镜　； 参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：评价电子输尿管软镜联合钬激光治疗肾结石的临床应用价值,讨论影响碎石成功率、结石排净率的因素及手术操作经验。方法：回顾性研究于2012年3月至2013年9月在我院使用奥林巴斯电子输尿管软镜联合钬激光治疗108例肾结石患者,其中结石分布肾盂41例,肾上中盏结石52例,肾下盏结石15例。先使用F9.8输尿管硬镜探查患侧输尿管,置入导丝后留置输尿管软镜鞘,引入输尿管软镜,蚕食法钬激光碎石,并使用套石篮套取出较大的结石碎屑。4周后复查KUB或双肾CT平扫,评估结石治疗效果：未排出结石碎片≥4mm者为有临床意义的结石残留。结果：在全部108例患者中,一次进镜成功率93.5%(101/108)。108例软镜成功进镜后,105例成功找到结石,术中寻找结石成功率97.2%(105/108),肾盂及肾上、中盏肾结石寻及率为98.9%(92/93),肾下盏结石寻及率为86.7%(13/15)；105例寻找到结石中有98例成功碎石,总碎石成功率93.3%(98/105)；下盏结石碎石成功率76.9%(10/13),中上盏及肾盂内结石的碎石成功率95.7%(88/92),两组之间差异有统计学意义(χ2=6.605,α=0.05,P0.05)。患者术后1个月后来我院复查其中97例结石完全清除或残余结石4mm,总结石排净率88.0%(95/108)；肾盂内及肾中上盏结石术后排净率92.5%(86/93),肾下盏结石术后排净率73.3%(11/15),两者之间差异有统计学意义(z2=5.281,α=0.05,P0.05)结论：电子输尿管软镜联合钬激光碎石,视野清晰,微创安全,是治疗直径20mm肾结石的安全有效的手段；肾盂内及肾中上盏结石较肾下盏结石,寻及率,碎石成功率和结石术后排净率高,有良好的临床应用价值。
[Abstract]:Objective: to evaluate the clinical value of electronic ureteroscopy combined with holmium laser in the treatment of renal calculi, and to discuss the factors affecting the success rate of lithotripsy, stone removal rate and operative experience.Methods: from March 2012 to September 2013, 108 patients with renal calculi were treated with Olympus electronic ureteroscope combined with holmium laser, including 41 cases of renal pelvis, 52 cases of upper calyceal stones and 15 cases of subrenal calyceal stones.The affected side ureter was examined with F9.8 ureteroscope, then the ureteral soft lens sheath was placed, the ureter soft lens was introduced, the holmium: YAG laser lithotripsy was used, and the larger stone fragments were removed with the stone basket cover. After 4 weeks, KUB or double kidney CT plain scan were reexamined.To evaluate the effect of stone treatment: those with no stone fragments 鈮，

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