经皮肾镜下2μm激光碎石治疗肾铸型结石55例分析

Percutaneous nephrolithotripsy with 2 μm laser in treating nephritic staghorn calculi

目的探讨经皮肾镜下2μm激光治疗肾铸型结石的有效性、安全性及相关技巧。方法采用经皮肾镜下2μm激光治疗肾铸型结石患者55例,其中双侧肾铸型结石8例。结果 55例患者中,一次碎石成功率为74.5%,手术平均时间70min;术后恢复快、并发症少;随访3个月,无残余碎石,肾积水均有不同程度减轻或消失。结论经皮肾镜下2μm激光治疗肾铸型结石是安全、有效的微创治疗方法,具有避免开放手术、手术时间短、恢复快、创伤小等优点。

Objective To investigate the efficacy, safety and techniques of percutaneous nephrolithotripsy with 2μm laser in treating nephritic staghorn calculi. Methods The clinical data of 55 patients treated with PCNL with 2μm laser during January 2008 to December 2009 were analyzed. Results Among 55 cases of nephritic staghorn calculi,all calculi were successfully fragmen- ted, the one-time calculi clearance rate was 74.5%（41/55） and the clearance time was 40--120 rain（mean 70 min）. No severe complications such as massive haemorrhage, ureteral perforation,conglutinant stenosis happened. Infection or recurrence was observed duringthe postoperative follow-up for 3 months, and no recurrence was found. Conclusion The percutaneous nephrolithotripsy with 2μm laser in treating nephritic staghorn calculi could avoid patency operation, reduce the operation time, have a quick recovery and take small wound for patients. So this method has the advantages of safety and efficacy, and has higher value for widespread application in clinic.