經(jīng)皮腎穿刺微造瘺輸尿管鏡雙頻雙脈沖激光碎石術(shù)治療復(fù)雜性腎結(jié)石(附35例報(bào)告)

【摘要】 目的： 探討經(jīng)皮腎穿刺微造瘺 (mini�睵CNL)治療復(fù)雜性腎結(jié)石的安全性及有效性。方法：采用經(jīng)皮腎穿刺微造瘺輸尿管鏡雙頻雙脈沖(U100) 激光碎石術(shù)治療復(fù)雜性腎結(jié)石35例。結(jié)果：23例結(jié)石一次取凈，6例結(jié)石二次取凈，4例結(jié)合體外震波碎石排凈，2例有少量結(jié)石殘留。結(jié)論：經(jīng)皮腎穿刺微造瘺結(jié)合U100激光碎石術(shù)治療腎結(jié)石具有創(chuàng)傷小、安全有效、恢復(fù)快、痛苦少的優(yōu)點(diǎn),是治療復(fù)雜性腎結(jié)石的良好方法之一。

【關(guān)鍵詞】 腎結(jié)石 經(jīng)皮腎微造瘺碎石術(shù) 雙頻雙脈沖激光

Minimally invasive percutaneous nephrolithotomy with the frequency doubled�瞕ouble pulse laser in treatment of complicated renal stone(report of 35 cases)

ZHANG Yu, WANG Qing, NI Ze�瞔hen, et al

(Department of Urology, The People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China)

Abstract : 　Objective: To evaluate the effect and safe of minimally invasive percutaneous nephrolithotomy (MPCNL) with the frequency�瞕oubled�瞕ouble pulse laser in the treatment of complex kidney calculi. Methods: Thirty�瞗ive cases with complex kidney calcul were treated with MPCNL and frequency�瞕oubled�瞕ouble pulse laser. Results: The stones were cleared off at one section in 23 cases ,two sections in 6 and 4 cases were cured by ESWL after two sections, 2 cases had a residual stone. Conclusions: MPCNL with the frequency�瞕oubled�瞕ouble pulse laser is less invasive, effective and safe in treatment of complicated renal stone.

Key words：　renal stone; minimally invasive percutaneous nephrolithotomy; frequency�瞕oubled�瞕ouble�瞤ulse laser

復(fù)雜性腎結(jié)石包括多發(fā)性、鹿角形、蹄鐵形、孤立腎和大于2.5 cm 的腎結(jié)石。以往這些復(fù)雜性腎結(jié)石的治療方法是開放性手術(shù)結(jié)合體外沖擊波碎石術(shù)(ESWL),手術(shù)難度大或需反復(fù)多次行ESWL ,并且行腎實(shí)質(zhì)切開取石術(shù)會造成術(shù)后腎實(shí)質(zhì)萎縮和腎功能損害等。近年來隨著經(jīng)皮腎微造瘺碎石取石術(shù)(minimally invasive percutaneous nephrolithotomy, MPCNL) 的發(fā)展，逐漸取代了傳統(tǒng)的開放手術(shù)[1], 成為腎結(jié)石的主要治療手段, 但對復(fù)雜性腎結(jié)石的治療仍非常棘手。2005年4月～2008年8月我院采用經(jīng)皮腎穿刺微造瘺輸尿管鏡雙頻雙脈沖(U100) 激光碎石術(shù)治療復(fù)雜性腎結(jié)石35例,效果滿意,現(xiàn)報(bào)告如下醫(yī).學(xué)全.在.線網(wǎng)站m.gydjdsj.org.cn。

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