经皮肾镜钬激光碎石术治疗肾结石103例

Clinical study of holmium laser lithotrity by percutaneous nephroscope in treatment of 103 cases with renal calculi

目的探讨微造瘘经皮肾镜钬激光碎石术治疗肾结石的临床效果及并发症的防治措施。方法彩超定位穿刺下，经皮微造瘘，采用狼牌（WOLF）8／9．8F输尿管硬镜，应用钬激光碎石机，功率设置在12—20w，进行碎石并联合取石钳取石。结果103例均穿刺成功。单通道碎石取石97例，双通道取石6例。全部病例主要结石均被取出，单纯肾盂或。肾盏结石取净率为96％，多发、铸型或鹿角型结石取净率为67％。手术时间一般为90—150min，特殊1例7h，术中明显渗血5例，手术结束时严重大出血1例，改开放手术，切除患肾，无周围脏器损伤及死亡病例。术后住院时间为7—15d。术后无行体外震波碎石病例。随访全部病例2—6个月，血尿、尿频、尿痛及腰部疼痛症状均消失，无结石复发。结论微造瘘经皮肾镜钬激光碎石术具有创伤小、并发症少、恢复快、一次清除结石率高、疗效确切等优点，值得临床推广使用。

Objective Discusses the clinical effect of makes the micro fistula after Pi Shenjing the holmium laser lithotrity treatment kidney stone and the complication prevention measure. Method Under the color ultra localization puncture, and after making the micro fistual, uses the wolf sign（WOLF） 8/9. 8 F ureter hard mirror, applies the holmium laser stone crusher, the power establishes in 12-20 W, carries on crushed stone parallel conjunction Shi Qianqu the stone. Results This group of 103 examples,the even puncture is successful. The single channel crushed stone takes the stone 97 examples, the double channel takes the stone 6 examples. The complete case main stone is taken out, the pure renal pelvis or the calyx stone takes leads is 96% only, sends, the cast or the antler stone takes only leads is 67%. Surgery time is 90- 150 min generally,the special 1 example 7 hours,in the technique the obvious oozing of blood 5 examples,the surgery ended when the serious massive hemorrhage 1 example ,changed the opening surgery,the excision trouble kidney,periphery did not have the internal organs damage and the death case. After the technique,is hospitalized the time is 7 -15 d. After the technique, poor character in vitro seismic wave crushed stone ease. Makes a follow-up visit the complete case 2 - 6 months, hematuria, frequent micturition, the urine pain and the waist ache symptom vanishes, non-stone recrudescence. Conclusion Micro makes the fistula after Pi Shenjing the holmium laser lithotrity has the wound to be small, the complication few, restores, unvoiced aspirated consonants to eliminate the stone rate high quickly, the curative effect accurate and so on merits, is worth the clinical promoted use.