经皮肾镜碎石联合钬激光治疗肾盏憩室结石(附11例报告)

Percutaneous nephrolithotomy combined with Holmium laser in the treatment of calyceal dverticular calculi(a report of 11 cases)

目的探讨经皮肾镜碎石联合钬激光治疗肾盏憩室结石的有效性与安全性。方法回顾性分析该院2010年12月-2014年5月采用经皮肾镜碎石联合钬激光治疗的11例肾盏憩室结石患者临床资料,其中,男性患者6例,女性患者5例;年龄21~67岁,平均53.6岁,结石位于肾下级9例,肾上级2例,术前均行肾盂逆行造影检查。采用B超引导,经皮穿刺肾盏憩室建立皮肾通道,应用四代EMS碎石系统粉碎并吸出结石,同时应用钬激光切开狭窄盏颈。结果所有手术均一期顺利完成,手术时间为25~95 min,平均36 min,术中失血量少,无输血病例,无中转开放手术,术中及术后未发生严重并发症,术后平均住院天数为6.5 d。结论经皮肾镜碎石联合钬激光治疗肾盏憩室结石疗效确切、安全可靠、创伤小,值得临床推广。

[ Objective ] To evaluate the efficacy and safety of percutaneous nephrolithotomy （PNL） combined with holmium laser for calyceal divertieular calculi. [ Methods ] Data of 11 patients （6 males and 5 females, average 53.6 years old） with calyceal diverticular calculi who had undergone PNL were retrospectively analyzed. Of thell cases, 9 had upper calyceal diverticular calculi, 2 had lower calyceal diverticular calculi, retrograde pyelogram was recommended before operation. PNL was performed, the narrow neck of the calyceal diverticulum was incised by holmium laser. [Results] All operations were successful with no transfusion and conversion to open ,the mean operation time was 25-95 min （average 36 min）, no severe complications occurred. [Conclusion] PNL combined with holmium laser in the treatment of calyceal diverticular calculi are safe and effective, worth to promotion in clinic.