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【摘要】 目的： 探討經(jīng)皮腎穿刺微造瘺 (miniPCNL)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 doubleddouble pulse laser in treatment of complicated renal stone(report of 35 cases)
ZHANG Yu, WANG Qing, NI Zechen, 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 frequencydoubleddouble pulse laser in the treatment of complex kidney calculi. Methods: Thirtyfive cases with complex kidney calcul were treated with MPCNL and frequencydoubleddouble 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 frequencydoubleddouble pulse laser is less invasive, effective and safe in treatment of complicated renal stone.
Key words： renal stone; minimally invasive percutaneous nephrolithotomy; frequencydoubleddoublepulse 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(kāi)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(kāi)取石術(shù)會(huì)造成術(shù)后腎實(shí)質(zhì)萎縮和腎功能損害等。近年來(lái)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(kāi)放手術(shù)[1], 成為腎結(jié)石的主要治療手段, 但對(duì)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(mǎn)意,現(xiàn)報(bào)告如下醫(yī).學(xué)全.在.線網(wǎng)站gydjdsj.org.cn。
