逆行输尿管镜钬激光碎石术治疗肾结石(附34例报告)

Retrograde Ureteroscopy Intrarenal Surgery(RIRS)with Holmium Laser Lithotripsy Treatment for Renal Calculi(a report of 34 cases)

目的探讨逆行输尿管镜联合钬激光碎石术治疗肾结石的临床疗效,寻求治疗肾结石的合理方法。方法回顾性分析2010年01月至2012年10月采用逆行输尿管镜联合钬激光治疗的34例肾盂结石患者临床资料。结果本组32例患者顺利进行碎石,2例肾盂内未见到结石,放置双J管后体外冲击波碎石(ESWL)治疗。术后形成输尿管石街患者6例,进行输尿管镜碎石取石术1次3例,2次2例,3次1例,术后首次治疗净石率76.5%(26/34),总体净石率88.2%(30/34)。结论应用逆行输尿管镜联合钬激光碎石术治疗肾盂结石,具有安全有效、创伤小、术后恢复快等优点,是微创治疗的有效方法之一。

Objective To investigate the clinical effect of retrograde ureteroscopic intrarenal sur- gery （RIRS） with holmium laser lithotripsy for renal calculi,seeking a reasonable method for the treatment of renal calculi.Methods A retrospective analysis was made on the 34 cases of re- nal calculi treated with retrograde ureteroscopic holmium laser lithotripsy from January 2010 to October , 2012. Results 32 cases were treated with lithotripsy.The 2 cases without stones in renal pelvis were treated with extracorporeal shock wave lithotripsy （ESWL） after indwelling double J.Ureteral steinstrasse were formed in 6 cases, of which 3 patients underwent RIRS once,2. patients twice,and 1 patient three times. The initial curative rate was 76.5% （2-6/34） ,the over- all curativee rate was 88.2-% （30/34）.Conclusion Being safe, effective, less invasive,faster in postoperative recovery,RIRS with holmium laser lithotripsy is one of the effective methods in the treatment of renal calculi.