资源描述:
《输尿管软镜治疗微创经皮肾术后残余结石--专业论文》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、输尿管软镜治疗微创经皮肾术后残余结石李勇曾荣王三富唐建牛张剑波郑宏李卿刘忠元湘南学院附属医院泌尿外科湖南郴州邮编423000[摘要]目的:探讨输尿管软镜治疗微创经皮肾术后残余结石的疗效。方法:采用输尿管软镜下钦激光碎石和取石钳取石术治疗微创经皮肾术后残余结石32例,结石大小0.4~1.2cm,平均0.8cim经留置输尿管扩张鞘或沿导丝直接置入美国顺康F7.9输尿管软镜抵达肾盂,寻及结石后以200urn光纤、10W功率钦激光碎石或用软性输尿管钳取石。结果:32例共有结石51枚,结石寻及率90.2%(46
2、/51),单次碎石成功率80.4%(41/51).其中上、中盏结石12枚,结石寻及率100%,单次碎石成功率91.7%(11/⑵;下盏结石39枚,结石寻及率87.2%(34/39),单次碎石成功率%(30/39)。无严重并发症发牛。结论:输尿管软镜治疗微创经皮肾术后残余结石安全、有效,尤其适川于结石体积较小、肾盏无明显积水,以及因解剖特点预期体外冲击波碎石效果不佳的患者。[关键词]残余结石;输尿管软镜;钦激光Holmiumlaserlithotripsywithflexibleureteroscope
3、forretainedcalculusbymPCNLAbstractObjective:ToexploretheeffectofholmiumlaserlithotripsywithflexibleureteroscropeforretainedcalculusbymPCNL.Methods:Thereare32caseswhowereadoptedholmiumlaserlithotripsywithflexibleureteroscopeandureterforcepsforretainedcal
4、culusbymPCNL・Lithogenoussizeis0.4-1.2cm,averageis0.8cm..Theflexibleureteroscropereachedpelvisthroughureterectasia-scabbardorguidewire,thecalculusremovedwereadoptedholmiumlaserlithotripsywithflexibleureteroscropewhichequipedwith200umopticalfiberandI0Wpow
5、erorflexibleureterforceps.Results:Therewerenoseriouscomplicationsoccurredin32cases.Therewere51calculus,therateofthatwecouldfindwas90.2%,80.4%oneswereachievementratiowhichhadbeenbrokenfirst.Therewere12onesinthesupra・andmeta-calyces,therateofthatwecouldfi
6、ndwas100%,91.7%oneswereachievementratiowhichhadbeenbrokenfirst.Therewere39onesintheinfra-calyces,therateofthatwecouldfindwas87.2%,76.9%oneswereachievementratiowhichhadbeenbrokenfirst.Conclusion:Holmiumlaserlithotripsywithflexibleureteroscopeforretainedc
7、alculusbyinPCNLissafeandeffective,particularlyapplicabletosmallerstonesandthereisnowaterinthecalyceal,aswellasthepatients9effectsexpectedofextracorporealshockwavelithotripsyispoorbecauseofanatomicalcharacteristics・Keywords:retainedcalculus,flexibleurete
8、roscope,Holmiumlaser目前,微创经皮肾手术是治疗肾结冇的主要手段,但手术后结石残留是困扰泌尿外科医牛的一个难题,而输尿管软镜技术则为微创经皮琢术后残留结石的处理提供了一条有效、安全的治疗途径。2008年4月〜2008年11月,我们应用输尿管软镜下治疗微创经皮肾术后残留结石32例,取得较好的疗效。现报告如下。1资料与方法本组32例,男18例,女14例;年龄20〜52岁,平均42岁。均因微创经皮肾术后经B超、静脉尿路造影等检杳确诊为残留结石