可视针形穿刺碎石一体镜联合尿石通治疗直径<1.5cm肾结石临床分析

doi:10.3969/j.issn.10056483.2019.02.014

摘要/Abstract

摘要： 目的：探讨4.8F可视针形穿刺碎石一体镜联合尿石通治疗直径<1.5cm肾结石的疗效及应用体会。方法：直径<1.5cm肾结石病人43例，采用4.8F可视针形穿刺碎石一体镜钬激光碎石术治疗。按是否服用尿石通分为两组：观察组（22例）术后口服尿石通、饮水量2500ml/d；对照组（21例）术后饮水量2500ml/d。比较两组病人术后3个月内无石率及结石排净时间。结果：观察组病人术后第1个月无石率为95.5％（21/22例），对照组为71.4％（15/21例），差异有统计学意义（P<0.05），观察组第2个月复查时结石均已排净，对照组第2个月为90.5%（19/21例）、第3个月为100%（21/21例），两组比较差异无统计学意义。观察组病人术后的结石排净时间为（1.05±0.21）个月，对照组为（1.38±0.67）个月，差异有统计学意义（P<0.05）。结论：4.8 F可视针形穿刺碎石一体镜钬激光碎石可有效粉碎直径<1.5cm肾结石，尿石通可促进术后残余结石排出，二者联合使用具有一定的临床运用价值。

关键词: 一体镜, 钬激光, 肾结石, 尿石通

Abstract: Objective：To investigate the efficacy and application of holmium laser lithotripsy with 4.8F visual needle puncture lithotripsy combined with Niaoshitong in the treatment of <1.5cm renal calculi.Methods：A retrospective analysis was made of the clinical data of 43 patients with renal calculi < 1.5cm treated by 4.8F visual needle puncture lithotripsy combined with holmium laser lithotripsy.The observation group received oral urolithotripsy and water 2500ml/day after operation，and the control group received water 2500ml/day after operation.The stonefree rate and stonefree time of the two groups within 3months after operation were compared.Results：There was no significant difference in age，sex and stone size between the two groups（P>0.05）.The stonefree rate of the observation group was 95.5%（21/22）in the first month after operation，compared with 71.4%（15/21）in the control group（P<0.05）.The stones in the observation group were cleared at the second month of reexamination，and 90.5%（19/21）in the second month and 100% in the third month of the control group.There was no statistical difference between the two groups（21/21）.The stone clearance time in the observation group was（1.05±0.21）months，which was shorter than that in the control group（1.38±0.67）months，with statistical significance（P<0.05）.Conclusion：4.8F visual needle puncture lithotripsy combined with holmium laser lithotripsy can effectively comminute kidney stones less than 1.5cm.Urolithotripsy can promote the excretion of residual stones after operation.The combination of the two methods has certain clinical application value.

Key words: integrated nephroscope, holmium laser, renal calculi, Niaoshitong

颜昌智, 潘铁军. 可视针形穿刺碎石一体镜联合尿石通治疗直径<1.5cm肾结石临床分析[J]. 临床外科杂志, 2019, 27(2): 129-131.

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