标准通道经皮肾镜钬激光碎石取石术联合微通道技术治疗复杂性肾结石的临床疗效观察

Clinical observation of standard channel percutaneous nephrolithotomy holmium laser lithotripsy combined with microchannel technology in treating of complex nephrolithiasis

目的评价标准通道经皮肾镜钬激光碎石取石术联合微通道技术治疗复杂性肾结石的安全性和临床疗效。方法采用标准通道联合微通道(F22+F16)经皮肾镜钬激光碎石取石治疗的复杂性肾结石病人90例,对手术时间、术中出血量、一期结石清除率和手术并发症等指标进行分析。结果 90例病人中共81例病人行一期标准通道联合微通道经皮肾镜钬激光碎石取石,术中出血量为(94. 71±20. 58) ml,一期总体清石率达为91. 11%,出现术后并发症9例,对症处理后均治愈(仅1例迟发性出血行介入栓塞治疗)。结论标准通道经皮肾镜钬激光碎石取石术联合微通道技术治疗复杂性肾结石净石率高、并发症低,治疗复杂性肾结石可行,安全有效。

Objective To evaluate the safety and clinical efficacy of standard transcutaneous holmium laser lithotripsy combined with microchannel technique in the treatment of complicated renal calculi. Methods Retrospective analysis of 90 cases of complex kidney stones in patients with clinical data in our hospital with a standard channel joint microchannel（ F22 ＋ F16） percutaneous nephroscope holmium laser lithotrips,and the operation time,intraoperative blood loss,the first phase of stone clearance rates and complications such as indicators for analysis. Results 81 cases were treated with stage Ⅰ standard channel joint microchannel percutaneous nephroscope holmium laser combined with microchannel technology,intraoperative blood loss was（ 94. 71 ± 20. 58） ml,the overall stone removal rate of stage Ⅰ reached 91. 11%,and the postoperative complications were 9 times in total,which were cured after treatment.（ Only 1 case of delayed hemorrhages line interventional embolization）. Conclusion Standard transcutaneous transcutaneous holmium laser lithotripsy combined with microchannel technology for complicated renal calculi has the advantages of high net stone rate and low complications,which can be used as a feasible,safe and effective surgical method for complicated renal calculi.