CAJ | 학술논문

目的：评价输尿管软镜结合钬激光治疗肾结石的有效性、安全性,分析影响输尿管软镜碎石成功率的影响因素。方法回顾分析2013年5月至2014年1月采用输尿管软镜下钬激光碎石术治疗肾结石25例,结石直径8~15mm,平均12mm。结石位于肾盂7例,中盏7例,下盏11例。术前留置J管2周,输尿管软镜寻及结石后,使用200μm钬激光光纤碎石。术后8周复查 KUB,评估结石排净率。结果24例顺利寻及结石(96．0%24/25),一次碎石成功88．0%(22/25),术后8周复查总结石排净率92．0%(23/25),手术时间平均65 min(40~130min),住院时间平均6d(5~7d),无输尿管穿孔、撕脱及大出血等严重并发症。结论输尿管软镜结合钬激光是处理直径<15mm肾结石的安全有效的手段。肾中盏及肾盂内结石较肾下盏结石碎石成功率高、结石排净率高。
목적：평개수뇨관연경결합화격광치료신결석적유효성、안전성,분석영향수뇨관연경쇄석성공솔적영향인소。방법회고분석2013년5월지2014년1월채용수뇨관연경하화격광쇄석술치료신결석25례,결석직경8~15mm,평균12mm。결석위우신우7례,중잔7례,하잔11례。술전류치J관2주,수뇨관연경심급결석후,사용200μm화격광광섬쇄석。술후8주복사 KUB,평고결석배정솔。결과24례순리심급결석(96．0%24/25),일차쇄석성공88．0%(22/25),술후8주복사총결석배정솔92．0%(23/25),수술시간평균65 min(40~130min),주원시간평균6d(5~7d),무수뇨관천공、시탈급대출혈등엄중병발증。결론수뇨관연경결합화격광시처리직경<15mm신결석적안전유효적수단。신중잔급신우내결석교신하잔결석쇄석성공솔고、결석배정솔고。
Objective To evaluate the efficacy and safety of flexible ureteroscope combined with Holmium laser for treat-ment of renal calculi, and to analyze the influencing factors of the success rate of lithotripsy. Methods We retrospectively re-viewed the date of 25 patients from May 2013 to January 2014 who underwent flexible ureteroscopic Holmium laser Lithotripsy. The diameter of the stones ranged form 8mm to 15mm with a mean of 12mm. Amongthe cases,the calculi were located at the renal pel-vis in 7 patients,at the middle calyx in 7,at the lower calyx in 11. A pig-tail stent would be set at the beginning of the procedure for 2 weeks. The stones were fragmentized by using 200μm Holmium Laser fiber. A follow-up by KUB was done 8 weeks after the procedure to evaluated the result of endoscopiec nephrolithotripsy. Results The calculi were detected in 24 patients(96. 0%,24/25),The success rate in a single procedure was 88. 0%(22/25),After 8 weeks,the total evacuation rate of the calculi was 92. 0%(23/25). The mean operative time was 65 min(40~130min),and mean hospital stay was 6d(5~7d). No serious complications were found, such as ureter perforation, avulsion and hemorrhage. Conclusion The flexible ureteroscope and Holmium laser litho-tripsy is safe and effective for renal calculi sized less than 15 mm in diameter, especially for those in the middle poles and renal pelvis.