经皮肾镜下钬激光碎石术治疗肾结石42例

Percutaneous nephroscope holmium laser lithotripsy in treatment of 42 patients with kidney stones

目的分析总结经皮肾镜下钬激光治疗肾结石的有效性及安全性,提高肾结石的治疗水平。方法回顾性分析经皮肾镜下钬激光碎石取石术治疗肾结石42例。患侧逆行置入F6输尿管导管后,在B超定位引导下进行肾穿刺,以筋膜扩张器递增扩张建立F18-22操作通道,在输尿管硬镜或肾镜下利用钬激光将结石击碎、取出,常规留置肾造瘘管和双J管。结果 42例中有39例(92.8%)一期碎石及取石,2例(4.7%)行二期碎石及取石,1例(2.3%)术中转开放性手术。平均结石清除率83.3%,手术时间(150±30)min,肾造瘘管平均留置5.5 d,平均术后住院时间6.7 d。结论经皮肾镜下钬激光碎石取石术治疗肾结石是有效和安全的。

Objective To evaluate the clinical efficacy and safety of percutaneous nephrolithotripsy. Methods The clinical data of42 inpatients,who were treated with percutaneous nephrolithotomy with the holmium laser from January 2009 to December 2011,were retrospectively analyzed. After placing F6 side retrograde ureteral catheter,a track from the skin surface into the renal calyx was established under B- type ultrasonography. After dilation,the sheath from 18F to 22F was passed in,and then. rigid ureteroscopy or nephroscopy was passed to introduce a holmium laser lithotriptor. Stones were broken up and a nephrostomy tube was placed in the incision to carry fluid from the kidney. Results Holmium laser percutaneous nephrolithotomy was completed in the first stage of the treatment in 39 cases(92. 8%),and was achieved in the second stage of the treatment in 2 cases(4. 7%),and open operation was required in 1 case(2. 3%). The stone- free rate was 83. 3%. The average operation time was(150 ± 30) min. The nephrostomy tube was left for 5. 5 days. The length of postoperative hospital stay was 6. 7 days. Conclusion Holmium laser percutaneous nephrolithotomy is effective and safe for the treatment of renal caculi.