| 摘要: |
| ［摘要］ 目的 探讨电子输尿管软镜钬激光碎石术治疗复杂性肾结石的临床效果。方法 该院2012-05～2015-04采用电子输尿管软镜钬激光碎石术治疗复杂性肾结石56例。所有患者术前不预先留置双J管。先F8.0/9.8输尿管硬镜置入患侧输尿管，观察输尿管情况留置导丝，沿导丝置入输尿管鞘，将输尿管软镜经鞘或直接沿导丝入镜至肾盂，观察肾盂及各肾盏并定位结石。然后进行钬激光碎石，尽可能将结石粉末化，直径>3 mm的结石尽可能用套石篮取出。结果 56例成功完成输尿管软镜钬激光碎石术。其中51例一次成功放置输尿管鞘，输尿管鞘放置成功率为91.0%（51/56），一次进镜成功率为96.4%（54/56），2例输尿管狭窄输尿管软镜无法上行，留置双J管1～2周后再次输尿管软镜手术成功。手术时间40～240 min，平均76 min。围手术期未发生严重并发症。术后3个月随诊，结石清除率为92.8%（52/56）。结论 电子输尿管软镜钬激光碎石术治疗复杂性肾结石视野清晰、安全有效。 |
| 关键词: 电子输尿管软镜 复杂性肾结石 钬激光 |
| DOI：10.3969/j.issn.1674-3806.2016.10.23 |
| 分类号:R 692.4 |
| 基金项目: |
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| Clinical analysis of electronic flexible ureteroscope with holmium laser lithotripsy for complex renal calculi |
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WANG Shi-jian, CHEN Shan-miao, LIU Shou-lei, et al.
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Department of Urology, the First People′s Hospital of Tongxiang, Zhejiang 314501, China
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| Abstract: |
| ［Abstract］ Objective To investigate the clinical effect of electronic flexible with ureteroscope holmium laser lithotripsy on complex renal calculi.Methods Fifty-six cases with complex renal calculi in our hospital from May 2012 to April 2015 were treated with electronic flexible ureteroscope and laser lithotripsy. A double-J tube was not indwelled in ureter before operation in each patient. F8.0/9.8 rigid ureteroscope was inserted to observe and dilate the ureteral lumen. Through the rigid ureteroscope, we introduced a wire into the ureter. Then, an Olympus electronic flexible ureteroscope was introduced into the pelvis. The stones were fragmented to less than 0.3 cm by holmium laser, and those more than 0.3 cm crushed stones were removed with a set of stone basket.Results A total of 56 operations were performed, in which 51 cases had successful placement of ureteral sheaths, and had ureteroscope entered successfully. The flexible ureteroscope failed to reach lower renal calyces in 2 cases because of the stricture of ureteral lumen, and they had to receive a second operation 1 to 2 weeks after double-J tube was retained. The operation time ranged from 40 to 240 min, with an average of 76 min. No serious complications occurred. After a 3-month follow up, stone clearance rate was 92.8%(52/56).Conclusion Electronic flexible ureteroscopy can provide clear vision. When combined with holmium laser, it is safe and effective to treat complex renal calculi. |
| Key words: Electronic flexible ureteroscope Complex renal calculi Holmium laser |
