经皮肾镜钬激光碎石术治疗肾结石

目的评价微创经皮肾镜(MPCNL)钬激光碎石术治疗肾结石的有效性和安全性。方法回顾性分析我院使用MPCNL钬激光碎石术治疗肾结石26例28侧的临床资料,结石直径2.0～5.5cm,平均(2.8±0.6)cm。分析钬激光碎石术碎石时间、结石排净率、并发症发生率等指标。结果MPCNL钬激光治疗28侧患肾,碎石取石时间为35～180min,平均(98.3±10.2)min,1次治疗结石取净率为75%(22/28),2次治疗后结石总取净率89.2%(25/28)。尿液转清平均时间为(38.1±5.4)h,无输血患者,无集合系统穿孔及输尿管狭窄并发症,1例术后发生高热,手术并发症发生率为3.8%(1/26)。3例残石接受药物或ESWL治疗,结石全部成功排出。同期治疗肾盂输尿管狭窄1例。结论MPCNL钬激光碎石术是治疗肾结石的有效方法,具有创伤小、并发症低等优点。

Treatment of renal calcili with holmium laser by minimally invasive percutaneous nephro-lithotripsy

Objective To assess the efficacy and safety of the holmium laser with minimally invasive percutaneous nephrolithotripsy(MPCNL) for renal calcili. Methods The holmium laser with MPCNL was performed on 26 patients (28 sides) with renal calcili. The average diameter of stone was 2.8±0.6(2.0-5.5)cm. Data on the operating time, stone-free rate and complication incidence were analyzed.Results The average operating time was 98.3±10.2(35-180)min,the stone-free rate was 75%(22/28)after the first session,89.2%(25/28)at the end of session. The average time of urine being clear was 38.1±5.4h. Blood transfusion, perforation and ureter obstruction did not occur.A febrile pyelonephritis occurred as a postoperative complication in one patient (3.8%). 3 cases of residual stones discharged after treatment by drug and ESWL.One case of ureteropelvic junction obstruction was treated at the same term.Conclusion The holmium laser with MPCNL is an effective and safe technique for renal calcili,and has the advantages of minimally invasion and low rate of complication.