中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
34期
100-101
,共2页
吕文伟%霍庆祥%孙建涛%杨金辉%郭伟立
呂文偉%霍慶祥%孫建濤%楊金輝%郭偉立
려문위%곽경상%손건도%양금휘%곽위립
经皮肾镜取石术%钬激光内切开成形术%输尿管上段结石%输尿管上段狭窄
經皮腎鏡取石術%鈥激光內切開成形術%輸尿管上段結石%輸尿管上段狹窄
경피신경취석술%화격광내절개성형술%수뇨관상단결석%수뇨관상단협착
Percutaneous nephrolithotomy%Holmium laser en doincision%Upper ureteral stone with stenosis%Ureteral stricture
目的:探讨经皮肾镜碎石联合钬激光内切开成形术治疗输尿管上段结石并狭窄的方法与疗效。方法:回顾性分析2008年6月-2012年6月本院收治的65例输尿管上段结石并狭窄患者的临床资料,男36例,女29例。年龄27~68岁,平均52岁。结石直径0.6~2.1 cm,平均(1.2±0.2)cm,合并肾积水2~6 cm,平均(3.5±0.2)cm。应用经皮肾镜碎石取石联合使用钬激光内切开成形术治疗。统计分析术后并发症、结石清除率及肾积水、肾小球滤过滤变化情况,对比手术前后IVU造影及CTU检查结果情况。结果:B超定位下65例手术均成功完成,清石率98.35%,无术中、术后大出血,无发热及其他重大并发症发生。术后随访6~36个月,平均12个月。肾积水明显减少56例,肾积水无明显变化9例,行输尿管镜下内切开术术后好转。术后患者IVU或者CTU肾显影改善。术后肾小球滤过滤由(15.2±5.9)mL/min升至(25.8±9.3)mL/min。结论:经皮肾镜联合钬激光治疗输尿管上段结石并狭窄是输尿管上段结石并狭窄安全有效的方法。
目的:探討經皮腎鏡碎石聯閤鈥激光內切開成形術治療輸尿管上段結石併狹窄的方法與療效。方法:迴顧性分析2008年6月-2012年6月本院收治的65例輸尿管上段結石併狹窄患者的臨床資料,男36例,女29例。年齡27~68歲,平均52歲。結石直徑0.6~2.1 cm,平均(1.2±0.2)cm,閤併腎積水2~6 cm,平均(3.5±0.2)cm。應用經皮腎鏡碎石取石聯閤使用鈥激光內切開成形術治療。統計分析術後併髮癥、結石清除率及腎積水、腎小毬濾過濾變化情況,對比手術前後IVU造影及CTU檢查結果情況。結果:B超定位下65例手術均成功完成,清石率98.35%,無術中、術後大齣血,無髮熱及其他重大併髮癥髮生。術後隨訪6~36箇月,平均12箇月。腎積水明顯減少56例,腎積水無明顯變化9例,行輸尿管鏡下內切開術術後好轉。術後患者IVU或者CTU腎顯影改善。術後腎小毬濾過濾由(15.2±5.9)mL/min升至(25.8±9.3)mL/min。結論:經皮腎鏡聯閤鈥激光治療輸尿管上段結石併狹窄是輸尿管上段結石併狹窄安全有效的方法。
목적:탐토경피신경쇄석연합화격광내절개성형술치료수뇨관상단결석병협착적방법여료효。방법:회고성분석2008년6월-2012년6월본원수치적65례수뇨관상단결석병협착환자적림상자료,남36례,녀29례。년령27~68세,평균52세。결석직경0.6~2.1 cm,평균(1.2±0.2)cm,합병신적수2~6 cm,평균(3.5±0.2)cm。응용경피신경쇄석취석연합사용화격광내절개성형술치료。통계분석술후병발증、결석청제솔급신적수、신소구려과려변화정황,대비수술전후IVU조영급CTU검사결과정황。결과:B초정위하65례수술균성공완성,청석솔98.35%,무술중、술후대출혈,무발열급기타중대병발증발생。술후수방6~36개월,평균12개월。신적수명현감소56례,신적수무명현변화9례,행수뇨관경하내절개술술후호전。술후환자IVU혹자CTU신현영개선。술후신소구려과려유(15.2±5.9)mL/min승지(25.8±9.3)mL/min。결론:경피신경연합화격광치료수뇨관상단결석병협착시수뇨관상단결석병협착안전유효적방법。
Objective:To evaluate the technique and clinical effect of PCNL combined holmium laser en doincision in the treatment of upper ureteral stone with stenosis.Method:Sixty-five patients including 36 males and 29 females who underwent PCNL combined holmium laser endoincision for upper ureteral stone with stenosis from June 2008 to June 2012 were retrospectively analyzed.The mean patient age was 52 years(range from 27 to 68 years),the mean stone size was(1.2±0.2)cm(range from 0.6 to 2.1 cm),the mean hydronephrosis size was(3.5±0.2)cm(range from 2 to 6 cm).All patients were treated with PCNL combined holmium endoincision.Postoperative complications,the stone clearance rate,hydronephrosis and GFR changes,IVU and CTU situation before and after surgery were analyzed.Result:Under ultrasonic guidance all the 65 operations were completed successfully.A 98.35%stone clearance rate was achieved,no serious complications such as hemorrhage,infection and fever were observed in intraoperation and postoperation.All patients were followed up for 6 to 36 months,average 12 months.56 patients with hydronephrosis improved significantly,9 patients with no significant changes but improved following holmium laser endoureterotomy.All patients achieved significant improvement in imaging study comparing of preoperative and postoperative data.GFR was raised from(15.2±5.9)mL/min to(25.8±9.3)mL/min after surgery.