输尿管肾镜下钬激光治疗肾结石

目的探讨输尿管肾镜下钬激光治疗肾结石的疗效及适应证。方法采用输尿管肾镜下钬激光碎石治疗肾结石25例。其中肾盂内结石18例,上盏4例,中盏3例;合并输尿管结石5例,肾盂输尿管连接部息肉1例,输尿管膀胱连接部狭窄1例。结果一次手术成功20例,2例行手术2次,3例手术2次合并体外冲击波碎石。手术时间20～80min,平均为45min,术后住院2～9d,平均3.5d。术后2个月复查结石基本完全排出,无明显并发症。结论输尿管肾镜下钬激光治疗肾结石安全有效,并发症少。但须掌握其适应证,初期易选择较小结石,随经验增加可以选择较大的结石,对复杂性肾结石宜采取分步骤、较为谨慎的方法。

Transurethral ureterorenoscopic treatment of renal calculi with Ho:YAG laser lithotripsy

Objective To investigate the clinical effect and indications of Ho：YAG laser lithotripsy through ureterorenoscope in the treatment of renal calculi.Methods Among the 25 cases of renal calculi underwent Ho：YAG laser treatment through ureteroscope,there were 18 with stones in pelvis , 4 in upper calices,3 in middle calices;5 eases combined with stones in ureter, one with polyp at ureteropelvic junction, one with stricture of ureterovesical junction.Results 20 cases underwent single treatment,3 cases were treated 2times,2eases received 2times of treatments and underwent extracorporeal shock wave lithotripsy.The operation time was 20-80min（mean time,45min）,post -operation hospitalization time was 2-10days （mean time,3.5 days）. The follow-up of 2 months showed all stones were removed without any complications.Conclusion Ureteroscopic Ho：YAG laser lithotripsy is a safe and effective method with less complications, but more attention should be paid to the indications,especially in early times.