单通道经皮肾镜取石联合胆道镜钬激光碎石术治疗复杂性上尿路结石的初步体会

Preliminary experience of single channel minimally invasive percutaneous nephrolithotomy combined with choledochoscope holmium laser lithotripsy in the treatment of complicated upper urinary calculi

摘要:

目的??探讨单通道经皮肾镜联合胆道镜钬激光碎石术治疗复杂性上尿路结石的临床效果。方法??2013年6月-2015年12月该院收治48例复杂性上尿路结石患者，均行经皮肾输尿管硬镜联合胆道镜钬激光碎石术治疗，统计分析其碎石时间、手术时间和结石清除率以及并发症等情况。结果??48例患者均Ⅰ期顺利建立皮肾通道；平均碎石时间（64.0±10.0）min；Ⅰ期结石清除率为93.18%，手术平均时间（95.0±16.0）min；均未发生严重并发症。结论??经皮肾镜联合胆道镜钬激光碎石术治疗复杂性上尿路结石一期结石清除率高，疗效显著，并发症少，值得临床推广。

Abstract:

Objective?To evaluate the technical feasibility and clinical efficacy of the single channel minimally invasive percutaneous nephrolithotomy combined with choledochoscope holmium laser lithotripsy. Methods?48 cases of complicated upper urinary calculi by operation from Jun 2013 to Dec 2015.The relevant factors of clinical outcomes were alaysized. Results?48 patients were in stageⅠsuccessfully established percutaneous renal access, one-stage stone clearance rate was 93.18 %, the average operation time (95.0 ± 16.0) min; the average time of stone processing (64.0 ± 10.0) min, no serious complication occurred in all patients. Conclusions?Minimally invasive endoscopic hard choledochoscope holmium laser lithotripsy for treatment of complicated upper urinary calculi has obvious curative effect, less complications, and a high stone clearance rate, reduce the risk of bleeding.