微创经皮肾镜钬激光碎石术治疗复杂性上尿路结石

目的探讨微创经皮肾镜钬激光碎石术治疗上尿路结石的临床效果。方法用钬激光技术通过微创经皮肾镜通道，对25例肾结石、12例输尿管上段结石患者实施治疗。结果肾结石一期粉碎排净20例，5例残石者残石大小0．5—0．8cm；2例经药物排石、3例经体外碎石治疗于术后1个月排净。输尿管结石者均一期粉碎排净。其中1例合并息肉，9例局部肉芽组织形成，2例为肉芽组织包裹，均采用钬激光切割。结石一期粉碎排净率为86．4％（32／37）。患者术后均恢复顺利，无严重并发症发生。结论微创经皮肾镜钬激光碎石是治疗上尿路结石的安全有效方法，尤其合并有肉芽和息肉形成者，具有创伤小、恢复快等优点。

Treatment of complicated upper urinary calculi with Ho: YAG laser lithotriptor by minimally invasive percutaneous nephrolithotomy

Objective To investigate the clinical outcomes of Ho: YAG laser lithotripter with minimal-ly invasive percutaneous nephrolithotomy incomplicated upper urinary calculi treatment. Methods Totally 12 eases of patients with upper ureteral calculi and 25 eases of renal calculi patients were treated with Ho: YAG laser lithotriptor by minimlly invasive percutaneous nephrolithotomy. Results All the upper ureteral calculi patients achieved stone-free at 1 session. And polypus( 1 ease) ,granulation(9eases) ,granulations wraped up(2 eases) were reseeted with Ho: YAG laser vaporization ablation. Of 25 eases with renal calculi 20 achieved stone free at 1 session. The remained stones ranged from 0. 5 to 0. 8 cm in 5 patients were expectorated in 1 month(2 eases treated by medicine and 3 eases treated by ESWEL). The overall successful stone fragmentation rate with stone-free ex-peetoration of the ureteral and renal calculi was 86. 4% ( 32/37 ). All the patients recovered well postoperatively and no major complications observed. Conclusion The technique of Ho: YAG laser lithotriptor with minimally invasive pereutaneous nephrolithotomy is safe and effective for the treatment of complicated upper urinary calculi, especially accompanied with polypus and granulation, and has advantages of minimal trauma and easy recovery.