肾盂切开钬激光碎石取石术治疗孤立肾巨大鹿角形结石的疗效观察

Combination with Pyelolithotomy and Holmium Laser Lithotripsy for the Removal of Complex Staghorn Renal Calculi in Solitary Kidney

目的:探讨和评价经肾盂切开钬激光碎石取石术治疗孤立肾巨大鹿角形结石的安全性和疗效。方法:回顾性分析接受经肾盂切开配合钬激光碎石取石术治疗的7例孤立肾巨大鹿角形结石患者的临床资料。结果:7例患者均手术顺利,术中出血量80～250 ml,平均150 ml、随访6～24个月,肾功能4例恢复正常,3例接近正常值范围,复查B超无结石残留。结论:该术式具有术中出血少、手术安全、对肾功能无明显影响、结石取净率高等优点,是一种处理孤立肾巨大鹿角形结石的较好方法。

Objective： To study the safety and eficacy of combination with pyelolithotomy and Holmium laser lithotripsy for complex staghorn renal calculi in solitary kidney. Methods： 7 cases of complex staghorn renal calculi of solitary kidney underwnet pyelolithotomy combined with Holmium laser lithotripsy were reviewed. Results：The procedure was completed successfully in all the 7 cases. The intraoperative blood loss ranged from 80 to 250 ml （mean 150 ml）. During the follow-up（6-24 months）, d cases had normal renal function, and 3 cases closed to normal range. B ultrasound showed no residual stones. Conclusions： This procedure owns the advantages of less bleeding, slight impairment of renal function, and high stone free rate. It is a good approach for the removal of complex staghorn renal calculi in solitary kidney.