输尿管软镜下钬激光碎石术治疗肾结石观察

目的探讨输尿管软镜下钬激光碎石术治疗肾盂。肾盏结石的可行性及疗效。方法采用输尿管软镜下钬激光碎石术治疗肾盂肾盏结石56例。经导丝留置输尿管扩张鞘至肾盂，通过输尿管扩张鞘直接置入帕立分体式输尿管软镜抵达肾盂，寻及结石后以260μm光纤、10～15w功率钬激光碎石。结果肾盂结石16枚，全部寻及并碎石成功，寻及率及碎石成功率100％。肾脏中、上盏结石44枚，寻及42枚并碎石成功，结石寻及及碎石率95．5％。肾脏下盏结石9枚，寻及8枚结石，7枚碎石成功。结石寻及率88．8％，碎石成功率77．8％。无严重并发症发生。结论输尿管软镜下钬激光碎石术治疗肾盂肾盏结石安全、有效，尤其适用于结石体积较小、肾盏无明显积水，以及因解剖特点预期体外冲击波碎石效果不佳的患者。

Treatment of renal and calyceal stones by holmium laser lithotripsy via flexible ureteroscopy

Objective To investigate the feasibility and efficacy of holmium laser lithotripsy via flexible ureteroscopy for the treat- ment of renal and calyceal stones. Methods A total of 56 patients with renal and calyceal calculi were treated by holmium laser via flexible ureterorenoscopy. We placed the dilated ureter sheath in renal pelvis through the guide wire, and then placed the pari- caleitol spilt flexible ureterorenoscope to reach the renal pelvis, searching for the stones and crushing it by 260 p~m fiber and holmi- um laser of 10 - 15 W. Results Sixteen pieces of pelvis calculi were all found and treated successfully, with a success rate of 100%. A total of 44 kidney stones were in the upper and middle calyxes, and 42 of the 44 were found and crushed successfully, with a rate of 95.5%. There were 9 stones in lower calyxes, 8 （88.8%） of which were found, and 7 of the 8 were crushed suc- cessfully with a success rate of 77.8%. No severe complications occurred. Conclusion Treating renal pelvis and renal calyceal cal- culi by holmium laser lithotripsy via flexible ureterorenoscopy is safe and effective, especially for the patients with small stones and without obvious water in renal calyx.