CAJ | 학술논문

目的探讨球囊扩张建立标准经皮肾镜通道下钬激光治疗复杂上尿路结石的安全性及临床疗效.方法选取河北大学附属医院采用球囊扩张建立标准经皮肾镜通道钬激光治疗复杂上尿路结石38例患者的临床资料.患者女性20例,男性18例,平均年龄38.3岁;结石直径2.0~4.2 cm,平均2.8 cm.其中肾上盏憩室结石15例,肾中盏憩室结石15例,肾盂及输尿管上段结石8例.均采用超声定位引导穿刺,应用钬激光碎石.结果1例因积水不明显,通道建立困难,再次建立通道,一期成功取石,余37例患者均一期经皮肾镜成功取石.术后复查38例患者均无结石残留.手术时间为30~98 min,平均45 min;术中出血10~65 mL,平均25 mL.无术后严重并发症发生,无中转开放手术患者,术后7~14 d出院.结论球囊扩张建立标准经皮肾镜通道钬激光碎石具有创伤小、出血少、清石率高、手术时间短等优点,为上尿路结石患者提供一种较好的治疗手段.
목적탐토구낭확장건립표준경피신경통도하화격광치료복잡상뇨로결석적안전성급림상료효.방법선취하북대학부속의원채용구낭확장건립표준경피신경통도화격광치료복잡상뇨로결석38례환자적림상자료.환자녀성20례,남성18례,평균년령38.3세;결석직경2.0~4.2 cm,평균2.8 cm.기중신상잔게실결석15례,신중잔게실결석15례,신우급수뇨관상단결석8례.균채용초성정위인도천자,응용화격광쇄석.결과1례인적수불명현,통도건립곤난,재차건립통도,일기성공취석,여37례환자균일기경피신경성공취석.술후복사38례환자균무결석잔류.수술시간위30~98 min,평균45 min;술중출혈10~65 mL,평균25 mL.무술후엄중병발증발생,무중전개방수술환자,술후7~14 d출원.결론구낭확장건립표준경피신경통도화격광쇄석구유창상소、출혈소、청석솔고、수술시간단등우점,위상뇨로결석환자제공일충교호적치료수단.
@@@@Objective To explore the safety and clinical efficacy of the balloon dilatation establishing standard percutaneous nephrolithotomy(PCNL) channel under holmium laser treatment for complex upper urinary tract stones. Methods Selected the clinical data of 38 patients in the Affiliated Hospital of Hebei University(20 females and 18 males, the average age is 38.3 years) with complex upper urinary tract calculi who were treated by the holmium laser under the balloon dilation establishing standard PCNL channel, including 15 cases of upper calyx diverticular calculi, 15 cases of light diverticulum kidney stones and 8 cases of renal and upper ureteral stones. The stones diameter was 2.0-4.2 cm, average 2.8 cm. All patients were treated with the holmium laser, punctured by ultrasound-guided. Results One case was difficult to establish the channel due to light obvious hydrocephalus and was re-established the channel. The renal access was successfully established in 37 patients and the stones were cleared out in all cases in the first stage of treatment, the calculus clearance rate was 100%. Postoperative examination of 38 patients had no residual stones. The operation duration was 30-98 minutes, averaged 45 minutes. The blood loss was 10-65 mL, averaged 25 mL. There were no serious complications and no cases converting to open surgery cases. The length of postoperative hospital stay was 7-14 days. conclusion The balloon dilatation establishing standard PCNL channel, and holmium laser lithotripsy has the advantages of fewer trauma, less bleeding, high stone clearance rate, shorter operative time and provides a better treatment for patients with upper urinary tract stones.