输尿管软镜下钬激光治疗肾结石效果观察

发布时间：2018-05-04 07:01

本文选题：输尿管软镜 + 钬激光　；参考：《山东医药》2017年18期

【摘要】：目的探讨输尿管软镜下钬激光治疗肾结石的安全性及有效性。方法采用输尿管软镜下钬激光治疗肾结石126例,术前2周给予留置双J管扩张输尿管,术后第1、4周复查腹部X线平片了解碎石情况及双J管位置,阴性结石采用CT平扫评估。结果 126例患者均一期成功碎石,手术时间(86±25)min,术后住院时间(4.5±1.6)d。术后1周结石清除率64.3%(86/126),术后4周结石清除率89.7%(113/126)。8例二次行输尿管软镜钬激光碎石后排出,5例行体外冲击波碎石后排出。术后当日发热5例,经抗感染治疗后痊愈。术后3个月复查,91例术前肾功能正常者术后肾功能无明显变化,35例术前肾功能不全者肾功能较术前好转7例、恢复正常28例。结论输尿管软镜下钬激光治疗肾结石创伤小,并发症少,术后恢复快,安全有效。
[Abstract]:Objective to evaluate the safety and efficacy of holmium laser under soft ureteroscopy in the treatment of renal calculi. Methods 126 cases of renal calculi were treated with holmium laser under soft ureteroscope. The ureter was dilated with indwelling double J tube 2 weeks before operation. X-ray plain film of abdomen was reexamined to understand the lithotripsy and the location of double J tube at the 1st week after operation. Ct plain scan was used to evaluate the negative stone. Results all 126 patients were successfully treated with primary lithotripsy, the operative time was 86 卤25 minutes, and the postoperative hospitalization time was 4.5 卤1.6 days. One week after operation, the stone clearance rate was 64.3% and 86 / 126% respectively. At 4 weeks after operation, the stone clearance rate was 89.7% and 11.3% / 1266..8 cases were treated with ureteral soft endoscopy holmium: YAG laser lithotripsy, and 5 cases were treated with extracorporeal shock wave lithotripsy (ESWL). 5 cases of fever were cured after anti-infection treatment. Three months after operation, the renal function of 91 patients with normal renal function before operation was not obviously changed after operation. The renal function of 35 patients with renal insufficiency before operation was better than that of 7 patients with renal insufficiency before operation, and 28 patients returned to normal. Conclusion Holmium laser under soft ureteroscope is safe and effective in the treatment of renal calculi with less trauma and less complications.
【作者单位】：滨州医学院烟台附属医院;
【分类号】：R699.2

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