CAJ | 학술논문

目的探讨经输尿管镜钬激光碎石术治疗输尿管结石的安全性和有效性.方法回顾总结我院自2005年12月至2009年7月间,应用经输尿管镜钬激光碎石术治疗输尿管结石180例(其中男95例,女85例),输尿管上段结石45例,中下段结石135例,结石直径大小0.5～3.0 cm,平均1.2 cm.观察手术成功率、手术时间、术后住院时间、并发症等.结果单次碎石成功率95%(171/180),其中输尿管上段86.7%(39/45),中下段97.8%(132/135).未成功的9例中,4例结石上移至肾盂,均为输尿管上段结石,5例因进镜失败中转开放手术.手术时间18～120 min,平均43 min,术后住院时间1～8 d,平均3.5 d.并发症发生率4.44%(8/180),其中输尿管穿孔4例,均为输尿管上段结石,术后持续高烧3例(其中1例同时出现持续血尿),术后并发肾绞痛并48 h无尿1例.结论经输尿管镜钬激光碎石术治疗输尿管结石尤其是输尿管中下段结石安全可靠,具有疗效肯定、损伤小、住院时间短等优点.
목적 탐토경수뇨관경화격광쇄석술치료수뇨관결석적안전성화유효성.방법 회고총결아원자2005년12월지2009년7월간,응용경수뇨관경화격광쇄석술치료수뇨관결석180례(기중남95례,녀85례),수뇨관상단결석45례,중하단결석135례,결석직경대소0.5～3.0 cm,평균1.2 cm.관찰수술성공솔、수술시간、술후주원시간、병발증등.결과 단차쇄석성공솔95%(171/180),기중수뇨관상단86.7%(39/45),중하단97.8%(132/135).미성공적9례중,4례결석상이지신우,균위수뇨관상단결석,5례인진경실패중전개방수술.수술시간18～120 min,평균43 min,술후주원시간1～8 d,평균3.5 d.병발증발생솔4.44%(8/180),기중수뇨관천공4례,균위수뇨관상단결석,술후지속고소3례(기중1례동시출현지속혈뇨),술후병발신교통병48 h무뇨1례.결론 경수뇨관경화격광쇄석술치료수뇨관결석우기시수뇨관중하단결석안전가고,구유료효긍정、손상소、주원시간단등우점.
Objective To Approach the safety and efficacy of ureteroscope holmium laser lithotripsy in the treatment of calculus of ureter.Methods Review summarize 180 patients of calculus of ureter who were underwent ureteroscope holmium laser lithotripsy from Dec 2005 to July 2009.95 males and 85 female patients.45 patients suffered from calculus in the superior segment of ureter and the other 135 case suffered from calculus in the mid-inferior segment of ureter.The average size of the calculus was 1.2 cm(0.5 ～3 cm).achievement ratio、time of operation 、length of stay after operation and the complications.Results The achievement ratio of macadam was 95 % (171/180) and 86.7 % (39/45) in superior segment of ureter and 97.8 % (132/135) in mid-inferior segment of ureter.In all the 9 failure patients,calculus moved up to pelvis in 4 case whose calculus were all in the superior segment of ureter,and 5 cases underwent open operation because of the failure of lens insertion.The average time of operation was 43 min(18 ～ 120 min).Length of stay after operation was 3.5 d(1 ～ 8 d).The complication rate was 4.44% (8/180) :Four patients suffered from ureter perforation calculus were all in the superior segment; three had persistence high fever and one of them also had persistence hematuria; one suffered from renal colic and anuria in 48 h.Conclusion Ureteroscope holmium laser lithotripsy is safe in the treatment of calculus of ureter,especially in those calculus of mid-inferior segment ureter.This operation has the merits of impressive curative effect,diminutive trauma,short length of stay and so on.