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目的:讨论新型组合式输尿管软镜下钬激光碎石术治疗肾结石的安全性和疗效,初步评价新型组合式输尿管软镜的临床应用价值。方法:我院2011年12月～2012年11月应用新型组合式输尿管软镜联合钬激光治疗肾结石患者37例,男19例,女18例,年龄35～65岁,平均50岁。结石位于肾盂22例,肾中、上盏12例,肾下盏3例。结石直径16～22mm,平均19mm。术后常规留置F5～6双J管和导尿管,评估手术时间、出血量及并发症情况。术后4周复查B超或KUB,评估结石排净率。结果:一次性碎石率89.1%(33/37)。手术时间45～160min,平均113min;术后住院2～5d,平均3d;结石排尽时间3～6周,平均4周。无脓肾、输尿管穿孔等并发症。结论:新型组合式输尿管软镜手术视野清晰,操作简便,克服了常规输尿管软镜维修费用昂贵的缺点,联合钬激光治疗肾结石安全,疗效满意。
OBJECTIVE: To discuss the safety and efficacy of holmium laser lithotripsy in the treatment of nephrolithiasis with the new combined ureteroscope, and to evaluate the clinical value of the new combined ureteroscope. Methods: From December 2011 to November 2012, 37 patients with nephrolithiasis were treated with new combination ureteroscope and holmium laser in our hospital. There were 19 males and 18 females, aged from 35 to 65 years, with an average of 50 years. Stones located in the renal pelvis in 22 cases, kidney, 12 cases of upper light, lower in the kidney in 3 cases. Stone diameter 16 ~ 22mm, an average of 19mm. Postoperative conventional F5 ~ 6 double J tube and urinary catheter, assess the operation time, bleeding and complications. 4 weeks after the review of B-or KUB, assessment of stone discharge rate. Results: The rate of disposable stone was 89.1% (33/37). Surgery time 45 ~ 160min, an average of 113min; postoperative hospital 2 ~ 5d, an average of 3d; stone row exhaust time of 3 to 6 weeks, an average of 4 weeks. No pus kidney, ureter perforation and other complications. Conclusion: The new combined ureteroscopic surgery has a clear field of vision and easy operation, which overcomes the shortcomings of conventional ureteral soft lens repair. The combined holmium laser treatment is safe and the curative effect is satisfactory.