[1]徐刚 李忠义 张哲伟张勇 陈继民 杜传军.电子输尿管软镜钬激光碎石治疗一期单通道经皮肾镜术后残石的安全性及疗效[J].中华腔镜泌尿外科杂志(电子版),2014,(03):184-187.
　Xu Gang,Li Zhong yi,Zhang Zhe wei,et al.Efficacy and safety of digital flexible ureteroscope combined with holmium laser lithotripsy for residual calculi after one stage single-tract percutaneous nephrolithotomy[J].,2014,(03):184-187.
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电子输尿管软镜钬激光碎石治疗一期单通道经皮肾镜术后残石的安全性及疗效()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2014年03期
页码:
184-187
栏目:
临床研究
出版日期:
2014-06-30

文章信息/Info

Title:
Efficacy and safety of digital flexible ureteroscope combined with holmium laser lithotripsy for residual calculi after one stage single-tract percutaneous nephrolithotomy
作者:
徐刚 李忠义 张哲伟张勇 陈继民 杜传军
310000杭州，浙江大学医学院附属第二医院泌尿外科
Author(s):
Xu Gang;  Li Zhong yi;  Zhang Zhe wei;  Zhang Yong;  Chen Jimin;  Du Chuanjun.
Department of Urology of the Second Affiliated Hospital of Medical School of Zhejiang University, Hangzhou 310000, China
关键词:
肾结石; 经皮肾镜; 输尿管软镜
摘要:
目的 总结电子输尿管软镜钬激光碎石治疗一期单通道经皮肾镜取石术（ PCNL）术后残石的安全性及疗效。方法 回顾性分析我院 2010年 5月至 2012年 12月期间，使用电子软性输尿管镜钬激光碎石术处理一期单通道经皮肾镜取石术后残石 41例，男 22例，女 19例，平均年龄（ 44±12）岁。术前结石均为复杂性鹿角形肾结石，术后残石 3例位于上盏， 6例结石位于中盏，7例位于下盏， 25例为多个肾盏残石，单枚结石 9例，结石直径 15～25 mm；其余均为多枚结石，结石直径 4~25 mm。再次手术时间为 PCNL术后 1~4周，软性输尿管镜碎石前，造瘘管已拔除 23例，仍保留肾造瘘管 18例。结果 41例患者均顺利地置入电子输尿管软镜，平均手术时间（ 83±31）min，术后平均住院时间（ 3±1）d。均无肾盂输尿管严重损伤、大出血、急性肾功能不全、感染性休克等并发症。术后 3个月复查超声或 CT提示，有意义结石残留（ ≥4 mm）5例： 2例为下盏残石，3例为多盏残石。中上盏碎石成功率 100%（9/9），下盏为 85.7%（6/7），多盏为 84.0%（21/25）。保留肾造瘘管及拔除肾造瘘管患者再次手术时间、术后住院时间、结石清除率及术后发热均无显著性差异。结论 在一期单通道 PCNL减轻肾结石负荷的情况下，电子输尿管软镜下钬激光碎石能有效清除残余结石，并发症少，可选择性地作为单通道一期 PCNL术后残留结石的治疗。

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备注/Memo

备注/Memo:
通讯作者：徐刚，Email：xug-mr@vip.sina.com
更新日期/Last Update: 2014-06-25