新型组合式输尿管软镜钬激光碎石术治疗2 CHI无积水.pdfVIP

医学临床研究 2013年 1o月 第 3o卷 第 10盟 es! ： ! ! ! · 论著 · 新型组合式输尿管软镜钬激光碎石术治疗2 CHI无积水 肾结石 舒建平 (湖南省怀化市第一人民医院泌尿外科，湖南 怀化 4180OO) [摘要]【目的】探讨新型组合式输尿管软镜钬激光碎石术治疗2cm无积水肾结石的安全性及有效性。 【方 法】入住本院的 36例2 cm 无积水 肾结石 的患者术前均行 经静脉尿路 造影术 (IVU)及 双 肾 CT检查 ，术 前 2周均留置双 J管，腰硬联合麻醉下行输尿管软镜钬激光碎石术，常规留置输尿管扩张鞘，较大结石用套石 篮取出，小结石术后体位排石。【结果]36例均顺利置入输尿管软镜，35例均可用输尿管软镜寻及结石，并成 功碎 石 。另外 1例 肾下盏结石二 次软镜碎石 ，术后仍残 留。碎石成功率 94．4 。平均手 术时间 90 rain，术后 平均住 院 日3 d，手术无并发症发生。术后随访 1～3个 月，患者症状均消失 ，未见结石复发 。【结论】新型组合 式输尿管软镜钬激光碎石术治疗2 cm无积水肾结石安全、有效，尤其适用于体外冲击波碎石效果不佳者。 [关键词] 肾结石／治疗； 输尿管镜； 激光，固体； 碎石术，激光 New M odular Flexible Ureteroscope with Holmium Laser Lithotripsy for the Treatment of Renal Calculi(：2era )W ithout Hydronephr0sis SHU Jian—ping (Department of Urology，First Peoples Hospital of Iiuaihua City，I-Iunan 418000，China) [-Abstract][Objective]To explore the safety and effectiveness of new modular flexible ureteroscope with holmium laser lithotripsy for the treatment of renal calculi(2cm)without hydronephrosis．[Methods]A to— tal 0f 36 renal caleuli( 2cm)patients without hydronephr0sis in our hospital received intravenous urography (IVU)and double kidney CT examination before the operation．Double J-tube was retained 2 weeks before the operation．All patients underwent flexible ureteroseope with holmium laser lithotripsy under combined spinal epidural anesthesia．Ureter expansion sheath was indwelled routinely．Large stones were taken out by using stone basket and smal stones were expelled through body position after the operation．[Results]All 3 6 pa— tients were placed with modular flexible ureteroscope smoothly．Modular flexible ureteroscope was available for finding stone in 35 cases and successfully crushed the stones．Another one patient with stone in the lower pole of kidney needed modular flexible ureteroscope tO crush stone twice and still had stone after the operation． The Success rate of crushing stone was 94．4 ．The average operation time and hospital stay were 90 minutes and 3 days。respectively．No severe complications