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目的探讨微创经皮肾镜钬激光碎石术治疗肾结石的安全性及疗效。方法患侧输尿管内置入F6输尿管导管,B超定位下选择中肾盏后组穿刺造瘘,建立F16经皮肾通道,输尿管肾镜直视下置入钬激光光纤将结石粉碎,利用灌洗压力将碎石颗粒冲出。结果手术时间90～240min,平均手术时间120min。结石清除率为86.87%(86/99)。13例术后残石患者行ESWL治疗。术后无继发性出血。术后住院时间4～12d,平均6.6d。随访全部病例2～6个月,腰部疼痛、血尿等症状均消失,无结石复发。结论微创经皮肾镜钬激光碎石术具有创伤小、出血少、并发症少、恢复快等优点且治疗效果令人满意,是治疗肾结石安全有效的方法。
Objective To investigate the safety and efficacy of minimally invasive percutaneous nephrolithotomy with holmium laser lithotripsy in the treatment of kidney stones. Methods The ureter of ipsilateral ureter was placed in F6 ureteral catheter, the middle calyceal group was selected by B-ultrasound, and the percutaneous nephrostomy was established. F16 percutaneous nephrostomy was established. Under direct ureteroscopic ureteroscopy, holmium laser fiber was used to crush stones. Using lavage pressure The gravel particles out. Results The operation time was 90 ~ 240min, the average operation time was 120min. Stone clearance rate was 86.87% (86/99). Thirteen patients with postoperative residual stone ESWL treatment. No secondary bleeding after surgery. Postoperative hospital stay 4 ~ 12d, an average of 6.6d. All patients were followed up for 2 to 6 months, waist pain, hematuria and other symptoms disappeared, no recurrence of stones. Conclusion minimally invasive percutaneous nephrolithotomy with holmium laser lithotripsy has the advantages of less trauma, less bleeding, less complications, faster recovery and satisfactory results. It is a safe and effective method for the treatment of renal stones.