硬性输尿管镜联合钬激光碎石术治疗反复发作肾绞痛38例

Rigid Ureteroscopy for Treatment of Recurrent Episodes Renal Colic: a Report of 38 Cases

目的探讨应用硬性输尿管镜与钬激光碎石术治疗反复发作肾绞痛的方法和影响结石排出的原因。方法对38例反复发作肾绞痛患者实施硬性输尿管镜并钬激光碎石术;用异物钳等器械配合处理结石或其他梗阻原因。结果成功解除梗阻36例,术后疼痛即刻缓解33例,1～2d后缓解3例。主要并发症为血尿21例,输尿管穿孔1例。术中发现影响梗阻解除的主要因素有输尿管口狭窄、水肿,结石形态不规则,结石下方输尿管狭窄以及息肉、妊娠、肥胖等。结论肾绞痛反复发作者可能存在影响输尿管通畅因素,硬性输尿管镜联合钬激光碎石术是治疗此类患者安全、有效的方法。

Objective To evaluate the clinical effect of rigid ureteroscopy for treatment of recurrent episodes renal colic. Methods A total of 38 patients with recurrent episodes renal colic were treated by rigid ureteroscopy and transureteroscope holmium laser hthotripsy and stones forceps were used to deal with the obstruction caused by stones and other factors. Results Reiief of obstruction was successful in 36 cases. Renal colic was immediately cured in 33 cases and were cured 1 - 2 days in 3 cases after operation. Primary complications were respectively blood urine in 21 case and boring hole of ureter in one case. It was found that influence factors were ureteric orifice stenosis and edema, irregular stones, ureterostenosis, polyp, pregnancy, obesity and so on. Conclusion Patients with recurrent episodes renal cohc have some correlative obstruction factors, and transurethral ureteroscopy is an effective and safe method for the treatment of recurrent episodes renal colic.