输尿管镜钬激光碎石术治疗肾结石的临床分析

Xue Yansi, X. Lei, X. Xiaojun, Wang Dukun, Wang Guocheng, Chen yi
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摘要

本研究旨在评估输尿管镜下钬激光碎石术治疗肾结石的临床价值。研究回顾性分析了2014年5月至2015年4月期间采用多镜联合柔性输尿管-输尿管镜钬激光碎石术治疗44例肾结石患者的临床数据。术后常规留置F4.7 D-J支架4周,导尿1-3天。术后几天还进行了肾脏、输尿管和肾盂(KUB)X光平片检查。第一次治疗后,共确定了 4 例成功病例。其余 40 例病例均先放置双 J 支架,一周后再进行手术。结石直径在 0.8-4.0 厘米之间。手术时间为 80-180 分钟。患者在 3-5 天内出院,双 J 支架在 1-3 个月内拆除。39 名患者在术后约三个月时完全无结石。但有五名患者在治疗后发现有11.1%的结石残留。没有输血、脓毒性休克、输尿管损伤或其他并发症的报道。输尿管软镜钬激光碎石术治疗肾结石安全有效。这种方法是治疗肾结石患者的重要选择。
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Clinical analysis of ureteroscopic holmium laser lithotripsy for the treatment of nephrolithiasis
The objective of the study is to evaluate the clinical value of ureteroscopic holmium laser lithotripsy for the treatment of nephrolithiasis. Clinical data of 44 patients treated for renal stones with polyscope modular flexible ureter- oscopic holmium laser lithotripsy from May 2014 to April 2015 were retrospectively analysed. Following the operation, F4.7 D-J stents were routinely indwelled for 4 weeks and catheterization for 1-3 days. A plain kidney, ureter, and blad- der (KUB) X-ray was performed on postoperative days too. A total of four success cases were determined following the first treatment. The remaining 40 cases were first placed with double-J stent and the surgery was performed one week later. Stone sizes between 0.8-4.0 cm in diameter were defined. The operation time for the treatment was 80-180 minutes. Patients were discharged within 3-5 days, and the double-J stent was removed within 1-3 months. 39 patients were found to be completely stone-free at approximately three months postoperatively. However, five patients were shown to have 11.1% of residual stones after treatment. No blood transfusion, septic shock, ureteral injury, or other complications were reported. Flexible ureteroscopic holmium laser lithotripsy is safe and effective for the treatment of nephrolithiasis. This approach could be a valuable choice for the treatment of patients with renal stones.
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