【摘要】 目的探讨微创经皮肾镜钬激光碎石治疗肾结石的临床疗效。方法连续硬膜外麻醉,经皮肾穿刺,建立手术通道,插入肾镜(WolfF8.5/11.5),见结石后,用200μm钬激光传导光纤(设置功率0.6～1.2J/6～10Hz)将结石粉碎并取出碎石屑。术后保留肾造瘘管3～5d,尿管5～7d,双J管4～8周。结果130例一期手术取石,手术时间40～150min,平均60min,术后住院时间7～10d,平均8.5d;15例二期手术取石,术后住院时间12～16d,平均14d;5例三期手术取石,术后住院时间15～20d,平均17d。150例均为单通道取石,一次手术结石取净率86.0%(129/150),总结石取净率92.0%(138/150)。150例无严重并发症发生。结论微创经皮肾镜钬激光碎石治疗肾结石微创、安全、有效。更多还原

【Abstract】 Objective To investigate the clinical efficacy of percutaneous nephrolithotomy with holmium laser(YAG laser lithotripsy)for the treatment of renal calculi.Methods Percutaneous puncture was performed under continuous epidural anesthesia,and then a pyeloscope(Wolf F8.5/11.5)was inserted and lithotripsy was carried out by using 200-μm holmium laser fiber(0.6-1.2 J/6-10 Hz).After the procedure,the pieces of the calculi were removed.After the operation,renal fistula was maintained for 3-5 d,urethral catheter was retained for 5-7 d,and double-J catheter was kept for 4-8 weeks.Results Stone removal was achieved with one-stage operation in 130 cases [mean operation time,60 minutes(40-150 minutes);and mean hospital stay,8.5 d(7-10 d)];with two-stage operation in 15 cases [mean hospital stay,14 d(12-16 d)];and with three-stage operation in 5 [mean hospital stay,17 d(15-20 d)].In all the 150 cases,by using single tract,stone-free rate reached 86.0%(129/150)after the first-stage operation,and final stone-free rate was 92.0%(138/150).None of the patients had severe complications after the operation.Conclusion Percutaneous nephrolithotomy by using holmium laser is minimally invasive,effective and safe for patients with renal calculi.更多还原