CAJ | 학술논문

目的：探讨结石CT值测定联合输尿管软镜单次治疗大负荷肾结石的安全性，有效性，可行性。方法通过结石CT值测定筛选＜800 HU的直径＞2 cm的肾结石患者16例。术前2周于膀胱镜下留置双J管，全身麻醉下行输尿管软镜钬激光碎石术，术后次日复查KUB，2周后复查CT明确碎石效果。结石残块≥4 mm为有意义结石残留，留置双J管至术后1个月再次复查KUB或CT，如仍有≥4 mm碎石则行体外冲击波碎石术。结果15例手术成功，1例术后有残余结石，直径8 mm，行体外冲击波碎石术后3周排出。手术时间30～90 min，平均40 min。所有病例均无二次手术。2例术后有发热，经加强抗感染输液对症处理后，体温降至正常。无输尿管穿孔、出血等重大并发症，术后住院2～4 d出院，平均2．4 d。结论结石CT值测定联合输尿管软镜单次治疗大负荷肾结石安全有效、可行。大负荷的肾结石，选择合适的病例进行合适的治疗相当重要。
목적：탐토결석CT치측정연합수뇨관연경단차치료대부하신결석적안전성，유효성，가행성。방법통과결석CT치측정사선＜800 HU적직경＞2 cm적신결석환자16례。술전2주우방광경하류치쌍J관，전신마취하행수뇨관연경화격광쇄석술，술후차일복사KUB，2주후복사CT명학쇄석효과。결석잔괴≥4 mm위유의의결석잔류，류치쌍J관지술후1개월재차복사KUB혹CT，여잉유≥4 mm쇄석칙행체외충격파쇄석술。결과15례수술성공，1례술후유잔여결석，직경8 mm，행체외충격파쇄석술후3주배출。수술시간30～90 min，평균40 min。소유병례균무이차수술。2례술후유발열，경가강항감염수액대증처리후，체온강지정상。무수뇨관천공、출혈등중대병발증，술후주원2～4 d출원，평균2．4 d。결론결석CT치측정연합수뇨관연경단차치료대부하신결석안전유효、가행。대부하적신결석，선택합괄적병례진행합괄적치료상당중요。
Objectives To appraise the safety , the efficacy and the feasibility of the combined the CT value measurement and flexible ureteroscopy for a single treatment of heavy stone burdens of kidney . Methods We choosed 16 cases of patients with kidney stones whose CT value measurement <800 HU. We routinely present the patient 2 weeks preoperation , and underwent flexible ureterorenoscopy ( URS )/holmium laser lithotripsy for renal stones under general anesthesia .KUB and CT were taken postoperative day and 2 weeks,respectively.meaningful Residual fragments defined as greater than 4 mm,which underwent extracorporeal shock wave lithotripsy .Results 15 cases were successful .1 case has a residual stone ,which has 8 mm in diameter, and three weeks later residual stone discharged after extracorporeal shock wave lithotripsy.Operation time 30 -90 minutes, mean 40 minutes.All cases were no secondary surgery .2 cases had fever postoperative , and temperature drop to normal after receiving antibiotics .No major complication such as ureter perforation, and bleeding.Stay hospital time from 2 to 4 days(mean 2.4 days).Conclusions The combination of CT value measurement and flexible ureteroscopy for a single treatment of heavy stone burdens of kidney is effective and feasible for the treatment of large burden kidney stones .It′s more important to choose appropriate cases for proper treatment .