激光碎石联合吸附清石术治疗上尿路结石75例观察.docVIP

修改稿201200411 （按照二审要求，加题目、单位和姓名的英文）xjt1966@126.com 大功率钬激光碎石联合吸附清石术治疗上尿路结石的疗效观察（附75例报告） 王强东 董振佳 肖旭 李建 袁秦波 淮安市淮阴医院泌尿外科 223300 江苏淮安 【摘要】目的 探讨大功率钬激光碎石联合吸附清石术治疗上尿路结石的临床疗效。方法：回顾总结应用吸附式大功率钬激光碎石术治疗上尿路结石75例的临床资料。结果：单通道取石71例，双通道取石4例，首次取尽结石69例，二次取尽结石1例，首次清石率为92℅（69/75），平均首次手术时间47.3min，平均术中出血量42.6ml。术后发热5例，无输血病例，无大出血、感染性休克、临近脏器损伤等并发症。结论：吸附式大功率钬激光碎石术治疗上尿路结石安全、有效。 【关键词】上尿路结石；钬激光；吸附清石 The clinical observation of the high-power holmium laser lithotripsy with adsorbing lithocenosis for upper urinary tract calculi. Wang Qiang-dong, Dong Zheng-jia, Xiao Xu, Li Jiang, Yuan Qin-bo. Department of Urology, Huaiying Hospital Huai’an City, Huai’an, 223300, China [Abstract] Objective: To evaluate the clinical effect of the high-power holmium laser lithotripsy with adsorbing lithocenosis for upper urinary tract calculi. Methods: A retrospectively analysis was performed on clinical data of 75 patients with upper urinary tract lithiasis which were treated by the high-power holmium laser lithotripsy with adsorbing lithocenosis. Results: Seventy-one patients were treated successfully via single tract and four via two tract. Sixty-nine patients of this group were treated successfully in the first session, and one patient after the second session. The stone clearance rate was 92％(69/75). The averaged time of operation in the first session was 47.3min. Mean estimated blood loss in operation was 42.6ml. The only postoperative complication was fever (5 cases), and there were no complications such as blood transfusion, massive hemorrhage, septic shock, and visceral injury. Conclusions: The high-power holmium laser lithotripsy with adsorbing lithocenosis for upper urinary tract calculi was a safe and effective method. [Key words] Upper urinary tract calculi, Holmium laser, Adsorbing lithocenosis 近20年来，我国学者提出的具有中国特色的微通道经皮肾穿刺取石术(MPCNL)，操作简单，适应症宽，应用更加广泛。钬激光和气压弹道是MPCNL的常用碎石工具，而吸附清石术更多见于标准通道经皮肾镜取石术(PCNL)。大功率钬激光联合吸附清石术应用于MPCNL的报道不多见。自2009年7月至2011年6月，我们应用大功率（65W）钬激光碎石联合吸附清石术治疗上尿路结石治疗上尿路结石75例，取得满意的疗效，现报告如下。 资