微创经皮肾镜钬激光碎石术治疗肾结石

目的探讨微创经皮肾镜钬激光碎石术治疗肾结石的安全性及疗效。方法患侧输尿管内置入F6输尿管导管,B超定位下选择中肾盏后组穿刺造瘘,建立F16经皮肾通道,输尿管肾镜直视下置入钬激光光纤将结石粉碎,利用灌洗压力将碎石颗粒冲出。结果手术时间90～240min,平均手术时间120min。结石清除率为86.87%（86/99）。13例术后残石患者行ESWL治疗。术后无继发性出血。术后住院时间4～12d,平均6.6d。随访全部病例2～6个月,腰部疼痛、血尿等症状均消失,无结石复发。结论微创经皮肾镜钬激光碎石术具有创伤小、出血少、并发症少、恢复快等优点且治疗效果令人满意,是治疗肾结石安全有效的方法。

Minimally invasive percutaneous nephrolithotomy with holmium laser for the treatment of renal calculi

Objective To explore the safety and efficiency of minimally invasive percutaneous nephrolithotomy with holmium laser for the treatment of renal calculi.Methods After retrograde placement of the ureteral catheter(F6),a track (F16)from the skin surface into the middle renal calyx was established under the guidance of a B-ultrasonography.Then a ureteroscope was passed to introduce a holmium laser lithotriptor.Stones were broken up and a nephrostomy tube was placed in the incision to carry fluid from the kidney.Results The duration of operation was 90~240 min (mean,120 min).The stone-free rate was 86.87%(86/99).13 cases with residual stone underwent extracorporal shock wave lithotripsy after the operation.No postoperative hemorrhage happened.The length of postoperative hospital stay was 4~12 d (mean,6.6 d).Follow-up observations in the 99 cases for 2-6 months showed complete relief of symptoms and no recurrent stone.Conclusion Holmium laser percutaneous nephrolithotomy is safe and effective in the treatment of renal calculi.