论文部分内容阅读
目的评价输尿管软镜下钬激光碎石术处理直径>2 cm肾和输尿管上段结石的可行性和安全性。方法采用输尿管软镜下钬激光碎石术治疗直径>2 cm肾和输尿管上段结石79例,其中结石直径2~3 cm者70例,3~4 cm者5例;鹿角形结石4例;多发结石38例,单发结石41例。术前2周留置双J管扩张输尿管,2周后行输尿管软镜下钬激光碎石取石术。结果 79例均成功入镜并碎石取石。2周后随访结石一次性清除率为78.48%(62/79),2次手术7例,3次手术1例,4次手术2例,平均手术次数1.2(1~4)次,最终结石清除率为88.61%(70/79)。术后发热4例,输尿管末段结石形成1例,“石街”形成2例,经积极处理后均痊愈出院。结论输尿管软镜下钬激光碎石术治疗2~4 cm肾和输尿管上段结石安全、有效,并可作为特殊情况下鹿角形结石的一种治疗手段。
Objective To evaluate the feasibility and safety of ureteroscopic holmium laser lithotripsy for the treatment of upper ureteral calculi with diameter> 2 cm. Methods Ureteroscopic holmium laser lithotripsy was used to treat 79 cases of kidney and upper ureteral calculi with diameter> 2 cm, including 70 cases with diameter of 2 ~ 3 cm and 5 cases with 3 ~ 4 cm in diameter, 4 cases with antler calculus, 38 cases of stone, single stone in 41 cases. Two weeks before surgery, double J tube dilated ureter, ureteroscopic holmium laser lithotripsy two weeks later. Results 79 cases were successfully into the mirror and gravel stone. One-time clearance rate was 78.48% (62/79) after 2 weeks. There were 7 cases of 2 surgeries, 1 case of 3 surgeries, 2 cases of 4 surgeries and 1.2 (1 ~ 4) surgeries. The final stone clearance The rate was 88.61% (70/79). Postoperative fever in 4 cases, ureteral stones formed in 1 case, “Stone Street ” formed in 2 cases, were cured after active treatment were discharged. Conclusions Ureteroscopic holmium laser lithotripsy is safe and effective in treating 2 ~ 4 cm renal and upper ureteral calculi, and can be used as a treatment for deer calculi in special cases.