CAJ | 학술논문

目的：评价输尿管软镜联合钬激光治疗肾盏内小结石的效果。方法2011年5月至2013年1月21例输尿管软镜钬激光碎石病例。术前均行逆行造影检查，明确输尿管及集合系统解剖位置正常。共52枚结石，结石直径0．5～1．5 cm。探查输尿管口置入斑马导丝，导丝引导下置入 F12输尿管软镜鞘，经鞘置入日本Olympus URF-V输尿管软镜，抵达目标肾盏行钬激光碎石。留置5 F双J管一根4周。结果2例无法置入输尿管软镜鞘，斑马导丝引导下置入输尿管软镜。钬激光碎石成功率100．0％（21/21）。4周后结石清除率为95．2％（20/21）。总的结石清除率为100．0％（81/86）。平均手术时间为42分钟（18～65分钟）。术后平均住院时间3．8天（3～5天）。无严重并发症。结论输尿管软镜钬激光碎石治疗1．5 cm以下肾多发结石安全有效。其结石排净率高、并发症少，创伤小、住院时间短。可以作为肾多发小结石的首选治疗方式。
목적：평개수뇨관연경연합화격광치료신잔내소결석적효과。방법2011년5월지2013년1월21례수뇨관연경화격광쇄석병례。술전균행역행조영검사，명학수뇨관급집합계통해부위치정상。공52매결석，결석직경0．5～1．5 cm。탐사수뇨관구치입반마도사，도사인도하치입 F12수뇨관연경초，경초치입일본Olympus URF-V수뇨관연경，저체목표신잔행화격광쇄석。류치5 F쌍J관일근4주。결과2례무법치입수뇨관연경초，반마도사인도하치입수뇨관연경。화격광쇄석성공솔100．0％（21/21）。4주후결석청제솔위95．2％（20/21）。총적결석청제솔위100．0％（81/86）。평균수술시간위42분종（18～65분종）。술후평균주원시간3．8천（3～5천）。무엄중병발증。결론수뇨관연경화격광쇄석치료1．5 cm이하신다발결석안전유효。기결석배정솔고、병발증소，창상소、주원시간단。가이작위신다발소결석적수선치료방식。
Objective To evaluate the efficacy of the flexible ureteroscopy with Holmium laser lithotripsy for renal calculi.Methods From May 2011 to Jan 2013, 21 cases of renal calculi(sized between 0.5 to 1.5cm in diameter , 72 calculi in total ) were treated by flexible ureteroscopy with Holmium laser lithotripsy in our hospi-tal.Observe the ureteric orifice and then a ureteric access sheath was placed and a Olympus URF -V flexible ureteroscopy with Holmium laser lithotripsy was used to perform the procedure , and a F5 double-J stent would be setup at the end of procedure for 4 weeks.Result In 2 cases the ureteric access sheath was failed to be placed.20 cases out of 21 (95.2%) had stone clearance at 4 weeks post primary operation , and the total stone clearance rate was 100% ( 21/21 ) .The average operation time was 42 minutes ( 18 ~65 mins ) .No serious complication occurred .Conclusion Flexible ureteroscopy combined holmium laser lithotripsy is a safe and effec-tive procedure for renal calculi , it has high clearance rate of stones and less complication and morbidity , it is the best option for managing small renal calculi .