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目的:探讨大功率钬激光经皮肾输尿管镜治疗复杂性肾结石的方法与效果。方法:应用大功率(60W,3.0 J,20 Hz)钬激光经皮肾输尿管镜治疗复杂性肾结石65例,其中多发性肾盂肾盏结石48例(平均直径3.1cm),鹿角状结石17例(平均直径5.3 cm),统计大功率钬激光碎石术碎石时间、结石取净率以及手术并发症等。结果:平均每次手术碎石取石时间为65(36～128)min,一次治疗结石取净率为69%(45/65),总的取净率为91%(59/65),术后5例出现发热,6例结合ESWL排净,3例有少量残留结石,1例术后出血较多行超选择性动脉栓塞后治愈,无其他并发症。结论:大功率钬激光经皮肾输尿管镜治疗复杂性肾结石能快速粉碎结石,缩短手术时间,出血量少,效率高,是治疗结石的安全、有效方法。
Objective: To investigate the method and effect of high power holmium laser percutaneous nephroureterectomy in the treatment of complicated renal calculus. Methods: 65 cases of complex nephrolithiasis were treated by high power (60W, 3.0 J, 20 Hz) holmium laser percutaneous nephrolithotomy, including 48 cases of multiple pyelolitholithiasis (mean diameter 3.1cm), 17 cases of antler calculus (Average diameter of 5.3 cm), statistical high-power holmium laser lithotripsy lithotripsy lithotripsy, stone removal rate and surgical complications. Results: The average stone removal time was 65 (36 ~ 128) min for each operation. The primary stone removal rate was 69% (45/65) and the total removal rate was 91% (59/65). After operation 5 cases had fever, 6 cases with combined ESWL row, 3 cases had a small amount of residual stones, 1 case of postoperative bleeding more than super-selective arterial embolization cure, no other complications. Conclusion: High power holmium laser percutaneous nephroureterectomy is a safe and effective method for the treatment of complicated calculus, which can crush the calculus rapidly, shorten the operation time, reduce the amount of bleeding and high efficiency.