宋乐明氏经皮肾碎石清石系统微通道下治疗上尿路结石

Treatment of Upper Urinary Calculi with Song Leming′s Percutaneous Nephrolithotripsy and Stone Clearance System via a Microchannel

目的探讨宋乐明氏经皮肾碎石清石系统单通道下治疗上尿路结石的效果。方法 2010年3月～2011年3月对52例上尿路结石使用宋氏经皮肾碎石清石系统,结合钬激光单通道下进行碎石清石,使用550μm光纤,钬激光功率1.0～2.0 J/40～50 Hz。结果 52例在单通道下完成手术,手术时间35～65 min,平均53 min。无肾、输尿管及其他脏器损伤,无败血症及感染性休克,无大出血等严重并发症。一次结石清除率96.2%(50/52)。住院时间5～8 d,平均7 d。留置双J管2～4周,拔管时复查B超无残石存留。48例随访3～6个月,无结石复发。结论宋乐明氏经皮肾碎石清石系统单通道可寻及肾各极各盏及输尿管上段,结合钬激光对结石低负压下进行有效同步碎石清石,安全快捷,操作简单。

Objective To evaluate the efficacy of Song Leming＇ s percutaneous nephrolithotripsy and stone clearance system via a single channel for upper urinary calculi. Methods Since March 2010 to March 2011, 52 patients with upper urinary calculi were treated with the Song＇ s percutaneous nephrolithotripsy and stone clearance system with Holmium laser （550 μm, 1.0 -2.0 J/40 -50 Hz）via a single percutaneous renal channel. Results The procedure was completed in all the 52 patients within 35 - 64 minutes with a mean of 53 minutes. No injury to the kidney, ureter, or other organs, sepsis, or infectious shock occurred. One-session stone clearance rate was 96.2% （50/52）. The mean hospital stay was 7 days （5 - 8 days）. Double-J tube was withdrawn in 2 - 4 weeks. B-ultrasonography showed no residual stones after that. Follow-up was achieved in 48 cases for 3 to 6 months, during which no recurrent stones were revealed. Conclusions With Song＇ s percutaneous nephrolithotripsy and stone clearance system, we can reach into each single calyx and upper ureter to remove stones completely. Combined with Holmium laser, it is a safe, convenient, simple, and effective operation.