一次性逆行肾内输尿管软镜钬激光碎石术一期治疗单侧肾结石的临床研究

Clinical study of disposable retrograde intrarenal flexible ureteroscopic holmium laser lithotripsy in the treatment of unilateral kidney stones

目的研究国产一次性逆行肾内输尿管软镜钬激光碎石术一期治疗单侧肾结石的有效性和安全性。方法回顾分析2021年1月至2021年12月期间岳西县医院泌尿外科收治一期输尿管软镜钬激光碎石术治疗单侧肾结石的患者共50例,包括左侧肾结石19例,右侧肾结石31例;肾上盏结石13例,肾中盏结石16例,肾下盏结石10例,肾盂结石11例。肾结石长径0.8~2.0 cm,平均(1.27±0.37)cm。手术均采用国产一次性逆行肾内输尿管软镜行钬激光碎石术。结果50例患者采用国产一次性输尿管软镜鞘均置入成功,一次碎石成功,手术成功率100%。手术时间20~50 min,平均(36.7±9.60)min。术后住院时间2~4 d,平均(2.68±0.71)d。术后4周结石清除率82%(41/50)。无尿脓毒血症、出血、穿孔及尿外渗等并发症。术后3个月结石清除率96%(48/50)。结论应用一次性逆行肾内输尿管软镜钬激光碎石术一期治疗单侧≤2 cm肾结石安全有效,结石清除率高,可在基层医院推广。

Objective To study the effectiveness and safety of domestic disposable retrograde intrarenal flexible ureteroscopic holmium laser lithotripsy in the first phase of the treatment of unilateral renal stones.Methods A total of 50 patients with unilateral renal stones were admitted in our department from January 2021 to December 2021,including 19 left,31 right,13 up,16 middle,10 lower and11 renal pelvis.Kidney stones were 0.8-2.0 cm long diameter with an average of(1.27±0.37)cm.Holmium laser lithotripsy was performed by domestic disposable retrograde intrarenal flexible ureteroscopy.Results All 50 patients were successfully implanted with domestic disposable soft ureteral sheath,with successful primary lithotripsy,and a success rate of 100%.The operation time was 20 to 50 minutes,and the average minute was(36.7±9.60)minutes.Postoperative hospital stay was 2 to 4 days,with a mean of(2.68±0.71)days.The stone clearance rate at 4 weeks after surgery was 82%(41/50).There were no complications such as urinary sepsis,bleeding,perforation,and urinary extravasation.Stone clearance at 3 months after surgery was 96%(48/50).Conclusion The treatment of single-sided2 cm kidney stones has high stone rate,which can be promoted in primary hospitals.