输尿管软镜钬激光碎石治疗肾输尿管上段结石150例_West China Medical Journal

Authors：

 张力 , 胡兴平 , 张川 , 王凯 , 李涵

成都市第五人民医院泌尿外科 (成都 611130);

Corresponding author：

Keywords：

肾输尿管上段结石; 输尿管软镜; 钬激光

DOI：

10.7507/1002-0179.201600199

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目的评价输尿管软镜钬激光碎石治疗肾输尿管上段结石的效果，探讨操作技巧。方法 2010年9月－2014年9月行输尿管软镜钬激光碎石治疗的肾输尿管上段结石患者150例，结石直径为0.8～4.2 cm。早期患者均先置F5双J管2周，再行输尿管软镜碎石。自2014年起均采用直接一期输尿管软镜碎石，术后3～5 d及术后4周复查腹部X线片及CT，评价碎石及排石效果。结果输尿管软镜一次性进镜率98.7%（148/150）；碎石成功率98.7%（148/150）；结石清除率97.3%（146/150）；手术时间20～126 min，平均40 min。2例术后出现尿源性败血症，经治疗缓解。结论输尿管软镜钬激光碎石手术创伤小，恢复快，并发症发生率低，结石排净率高，是治疗肾输尿管上段结石安全有效的方法。

Citation： 张力, 胡兴平, 张川, 王凯, 李涵. 输尿管软镜钬激光碎石治疗肾输尿管上段结石150例. West China Medical Journal, 2016, 31(4): 734-735. doi: 10.7507/1002-0179.201600199 Copy

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7.	叶利洪, 李雨林, 李王坚, 等. 肾下盏解剖结构对输尿管软镜下钬激光碎石治疗肾下盏结石疗效的影响[J]. 中华泌尿外科杂志, 2013, 34(1): 24-27.
8.	杨嗣星, 宋超, 刘凌琪, 等. 输尿管镜下钬激光碎石与经皮肾镜取石术治疗肾结石的疗效比较[J]. 中华泌尿外科杂志, 2013, 34(9): 666-669.
9.	Buscarini M, Conlin M. Update on flexible ureteroscopy[J]. Urol Int, 2008, 80(1): 1-7.
10.	Herrera-Gonzalez G, Netsch C, Oberhagemann K, et al. Effectiveness of single flexible ureteroscopy for multiple renal calculi[J]. J Endourol, 2011, 25(3): 431-435.
11.	刘齐贵, 张文滔, 段娟, 等. 输尿管软镜结合钬激光治疗肾结石的疗效观察[J]. 中国微创外科杂志, 2012, 12(3): 239-241.
12.	Pasqui F, Dubosq F, Tchala K, et al. Impact on activescope deflection and irrigation flow of all endoscopic working tools during flexible uroterocopy[J]. Eur Urol, 2004, 45(1): 58-64.
13.	Takazawa R, Kitayama S, Tsujii T. Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater[J]. Int J Urol, 2012, 19(3): 264-267.
14.	Ben Saddik MA, Al-Qahtani Sejiny S, Ndoye M, et al. Flexible ureteroscopy in the treatment of kidney stone between 2 and 3 cm[J]. Prog Urol, 2011, 21(5): 327-332.
15.	方建明, 王可兵, 夏宏辉, 等. 输尿管软镜联合钬激光碎石术治疗肾和输尿管上段结石: 附86例报告[J]. 中华腔镜泌尿外科杂志: 电子版, 2012, 6(1): 42-45.

1. Khoder WY, Bader M, Sroka R, et al. Efficacy and safety of Ho: YAG laser lithotripsy for ureteroscopic removal of proximal and distal ureteral calculi[J]. BMC Urol, 2014(8;14): 62.
2. Cansino Alcaide JR, Reinoso Elbers J, López Sánchez D, et al. Flexible ureterorenoscopy (URS): technique and results[J]. Arch Esp Urol, 2010, 63(10): 862-870.
3. Tondut L, Peyronnet B, Arnaud A, et al. Impact of the acquisition of a flexible ureteroscope on the management of upper urinary tract stones in children[J]. Prog Urol, 2016, 26(2): 96-102.
4. Pan J, Chen Q, Xue W, et al. RIRS versus mPCNL for single renal stone of 2-3 cm: clinical outcome and cost-effective analysis in Chinese medical setting[J]. Urolithiasis, 2013, 41(1): 73-78.
5. 刘东亮, 朱蜀侠, 袁丹, 等. 输尿管软镜联合输尿管硬镜钬激光碎石术治疗复杂性输尿管上段结石[J]. 四川医学, 2015, 36(5): 632-635.
6. Bryniarski P, Paradysz A, Zyczkowski M, et al. A randomized controlled study to analyze the safety and efficacy of percutaneous nephrolithotripsy and retrograde intrarenal surgery in the management of renal stones more than2cm in diameter[J]. J Endourol, 2012, 26(1): 52-57.
7. 叶利洪, 李雨林, 李王坚, 等. 肾下盏解剖结构对输尿管软镜下钬激光碎石治疗肾下盏结石疗效的影响[J]. 中华泌尿外科杂志, 2013, 34(1): 24-27.
8. 杨嗣星, 宋超, 刘凌琪, 等. 输尿管镜下钬激光碎石与经皮肾镜取石术治疗肾结石的疗效比较[J]. 中华泌尿外科杂志, 2013, 34(9): 666-669.
9. Buscarini M, Conlin M. Update on flexible ureteroscopy[J]. Urol Int, 2008, 80(1): 1-7.
10. Herrera-Gonzalez G, Netsch C, Oberhagemann K, et al. Effectiveness of single flexible ureteroscopy for multiple renal calculi[J]. J Endourol, 2011, 25(3): 431-435.
11. 刘齐贵, 张文滔, 段娟, 等. 输尿管软镜结合钬激光治疗肾结石的疗效观察[J]. 中国微创外科杂志, 2012, 12(3): 239-241.
12. Pasqui F, Dubosq F, Tchala K, et al. Impact on activescope deflection and irrigation flow of all endoscopic working tools during flexible uroterocopy[J]. Eur Urol, 2004, 45(1): 58-64.
13. Takazawa R, Kitayama S, Tsujii T. Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater[J]. Int J Urol, 2012, 19(3): 264-267.
14. Ben Saddik MA, Al-Qahtani Sejiny S, Ndoye M, et al. Flexible ureteroscopy in the treatment of kidney stone between 2 and 3 cm[J]. Prog Urol, 2011, 21(5): 327-332.
15. 方建明, 王可兵, 夏宏辉, 等. 输尿管软镜联合钬激光碎石术治疗肾和输尿管上段结石: 附86例报告[J]. 中华腔镜泌尿外科杂志: 电子版, 2012, 6(1): 42-45.

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West China Medical Journal

输尿管软镜钬激光碎石治疗肾输尿管上段结石150例

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