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目的评估输尿管软镜(F-URS)联合钬激光治疗有症状肾盏憩室(CD)结石的临床有效性与安全性。方法对32例有症状的CD结石患者采用F-URS联合钬激光治疗。CD结石位于肾上盏20例,肾中盏7例,肾下盏5例。CD结石直径10~25 mm,平均(17.1±5.6)mm。蓝染技术寻及CD流出道,使用200/365μm光纤,0.8 J/10 Hz(8 W)功率适度扩大憩室流出道,0.8~1.5 J/10~25 Hz(10~35 W)功率碎石。结果 F-URS联合钬激光处理有症状CD结石成功率为81.3%(26/32),96.8%(31/32)术后症状消失。CD结石不同位置成功率差异无显著性(P>0.05),但憩室流出道短程(≤5 mm)成功率明显高于长程者(>5 mm)(P<0.05)。平均手术时间为71 min(56~125 min),住院时间1~4 d,平均3 d。术后有2例出现发热,无其他严重并发症。结论 F-URS联合钬激光可以选择性作为治疗有症状CD结石的一种有效方法,具有微创、安全及高效的优点。
Objective To evaluate the clinical efficacy and safety of ureteroscopic (F-URS) combined with holmium laser in the treatment of symptomatic alveolar diverticula (CD) stones. Methods 32 patients with symptomatic CD stones were treated with F-URS combined with holmium laser. CD stones located in the upper 12 cases of renal, kidney in 7 cases, 5 cases of renal calyx. CD stones diameter 10 ~ 25 mm, with an average (17.1 ± 5.6) mm. The blue dye technique was used to find CD outflow tract. The 200/365 μm optical fiber and 0.8 J / 10 Hz (8 W) power were used to moderately divert diverticula outflow tract and 0.8-1.5 J / 10-25 Hz (10-35 W) power gravel. Results F-URS combined with holmium laser treatment of symptomatic CD stones success rate was 81.3% (26/32), 96.8% (31/32) symptoms disappeared. There was no significant difference in the success rate of CD stones between different locations (P> 0.05), but the success rate of diverticular outflow tract short-range (≤5 mm) was significantly higher than that of long-range (> 5 mm) The average operation time was 71 min (56 ~ 125 min) and the hospital stay was 1 ~ 4 days with an average of 3 days. There were 2 cases of fever, no other serious complications. Conclusions F-URS combined with holmium laser can be used as an effective method for the treatment of symptomatic CD stones. It has the advantages of minimal invasion, safety and high efficiency.