岭南现代临床外科
嶺南現代臨床外科
령남현대림상외과
LINGNAN MODERN CLINICS IN SURGERY
2014年
6期
691-693
,共3页
钬激光%输尿管结石%输尿管硬镜
鈥激光%輸尿管結石%輸尿管硬鏡
화격광%수뇨관결석%수뇨관경경
Holmium laser%Upper ureteral calculi%Rigid ureterorenoscopy
目的：探讨输尿管硬镜下钬激光碎石取石术治疗输尿管上段结石的临床效果及安全性。方法应用输尿管硬镜下钬激光碎石取石术治疗112例输尿管上段结石患者。男63例，女49例，年龄18～87岁（46．7±13．6岁），左侧61例，右侧46例，双侧5例。结石长径0．7～2．2 cm （1．2±0．5 cm）。26例合并输尿管息肉，31例曾行体外冲击波碎石术，所有患侧肾脏均合并不同程度肾积水。结果手术成功率88．4％（99／112），手术时间15～80 min（33．6±16．8 min），术后住院天数3～14天（4．7±2．1天）。所有患者均无严重肉眼血尿、输尿管穿孔、粘膜撕裂、输尿管镜石街形成等并发症。3例患者出现畏寒、高热，其中1例发展为尿源性脓毒血症，予以积极抗感染治疗后，症状逐渐缓解。结论输尿管硬镜下钬激光碎石取石术治疗输尿管上段结石是安全，有效的治疗方法。
目的：探討輸尿管硬鏡下鈥激光碎石取石術治療輸尿管上段結石的臨床效果及安全性。方法應用輸尿管硬鏡下鈥激光碎石取石術治療112例輸尿管上段結石患者。男63例，女49例，年齡18～87歲（46．7±13．6歲），左側61例，右側46例，雙側5例。結石長徑0．7～2．2 cm （1．2±0．5 cm）。26例閤併輸尿管息肉，31例曾行體外遲擊波碎石術，所有患側腎髒均閤併不同程度腎積水。結果手術成功率88．4％（99／112），手術時間15～80 min（33．6±16．8 min），術後住院天數3～14天（4．7±2．1天）。所有患者均無嚴重肉眼血尿、輸尿管穿孔、粘膜撕裂、輸尿管鏡石街形成等併髮癥。3例患者齣現畏寒、高熱，其中1例髮展為尿源性膿毒血癥，予以積極抗感染治療後，癥狀逐漸緩解。結論輸尿管硬鏡下鈥激光碎石取石術治療輸尿管上段結石是安全，有效的治療方法。
목적：탐토수뇨관경경하화격광쇄석취석술치료수뇨관상단결석적림상효과급안전성。방법응용수뇨관경경하화격광쇄석취석술치료112례수뇨관상단결석환자。남63례，녀49례，년령18～87세（46．7±13．6세），좌측61례，우측46례，쌍측5례。결석장경0．7～2．2 cm （1．2±0．5 cm）。26례합병수뇨관식육，31례증행체외충격파쇄석술，소유환측신장균합병불동정도신적수。결과수술성공솔88．4％（99／112），수술시간15～80 min（33．6±16．8 min），술후주원천수3～14천（4．7±2．1천）。소유환자균무엄중육안혈뇨、수뇨관천공、점막시렬、수뇨관경석가형성등병발증。3례환자출현외한、고열，기중1례발전위뇨원성농독혈증，여이적겁항감염치료후，증상축점완해。결론수뇨관경경하화격광쇄석취석술치료수뇨관상단결석시안전，유효적치료방법。
Objective To investigate clinical effect and safety of holmium: YAG laser lithotripsy under ureteroscopy for managing upper ureteral calculi. Methods The clinical data of 112 cases of ureter calculi treated by ureteroscope with Holmium laser lithotripsy were retrospectively analyzed. Among these patients, 63 were male, and 49 were female. The age of the patients varied between 18~87 years with a mean age of 46.7 years. The largest diameter of the largest stone was 0.7~2.2 cm (1.2±0.5 cm). There are 5 cases of bilateral upper ureteral calculi, and the total number of left upper ureteral calculi was 61, and the right side was 46. There were 26 cases affiliated with ureteral polypus, and 31 cases with ESWL treatment history preoperative. All the cases had different degrees of hydronephrosis. Results The overall successful operation rate for all level of ureteral stones in single procedure was 88.4% (99/112). The operation time ranged 15~80 min (33.6 ±16.8 min), and the postoperative hospital stay was 3~14 d (4.7 ±2.1 d). No complications occurred such as severe hematouria, ureteral perforation, ureteral avulsion and ureteral stone street in this post cohort operation. There were three cases with urinary tract infection and suffered fever. Urosepsis occurred in one case , and cured by timely anti-infection treatment. Conclusion Rigid ureterorenoscopy using Ho:YAG laser lithotripsy for upper ureteral calculi can be an effective and safely performed technique.
