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目的探讨新型组合式输尿管软镜钬激光碎石术治疗肾结石的有效性和安全性。方法回顾分析2012年11月至2013年9月收治的48例肾结石患者,采用新型组合式输尿管软镜钬激光碎石术治疗。按不同年龄、结石位置(肾盂、肾上中盏、肾下盏)、结石大小、术前是否行体外冲击波碎石治疗(ESWL)分组,术后清石率以出院前KUB复查结果和出院1个月、2个月后复查KUB或超声结果进行疗效评价。结果术中46例(95.83%)患者成功找到并粉碎结石;术后2例(4.17%)患者出现高热寒战;术后第3天复查KUB清石率为64.58%(31/48),术后1个月复查清石率为85.42%(41/48),按不同年龄、结石位置、结石大小、术前是否行ESWL治疗分组清石率比较差异无统计学意义(P>0.05);术后2个月复查清石率93.75%(45/48),因2个月后复查清石率较高各组未进行统计学比较。结论新型组合式输尿管软镜钬激光碎石术治疗肾结石具有清石率高并发症轻、发生率低等优势,值得推广。
Objective To investigate the effectiveness and safety of the new combined ureteroscopic holmium laser lithotripsy in the treatment of kidney stones. Methods Forty-eight patients with nephrolithiasis who were admitted to our hospital from November 2012 to September 2013 were retrospectively analyzed and treated with a new combined ureteroscopic holmium laser lithotripsy. According to different age, stone location (renal pelvis, middle of the kidney, lower extremity), stone size, preoperative ESWL group, the rate of postoperative stone discharge KUB review before discharge and discharge 1 Months, 2 months after review KUB or ultrasound results for evaluation. Results 46 cases (95.83%) were successful in finding and smashing stones in operation; 2 cases (4.17%) were feverish chills after operation; the rate of KUB clearing was 64.58% (31/48) on the 3rd day after operation, The rate of clear stone in one month was 85.42% (41/48). There was no significant difference in the rate of clear stone between the groups according to age, location of stone, size of stone, ESWL before operation (P> 0.05) The rate of clear stone in 2 months was 93.75% (45/48), but the rate of clear stone was higher in 2 months and no statistical comparison was made in each group. Conclusion The new combined ureteroscopic holmium laser lithotripsy has the advantages of clear rate and low complication, low incidence and so on. It is worth popularizing.