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目的探讨应用腔内镜技术,钬激光碎石治疗泌尿系结石的有效性和安全性。方法回顾性分析94例应用肾镜、输尿管镜、膀胱镜行钬激光碎石资料。结果40例肾结石,碎石取石时间74min(50-183min),单次碎石成功率89.9%(36/40),1例肾穿刺失败改开放手术,3例行Ⅱ期钬激光碎石;输尿管结石46例,碎石时间32mi(n20-57min),单次碎石成功率100%。膀胱结石6例,2例因结石过大碎石失败行开放手术取石,尿道结石2例,一次碎石成功。平均住院天数8(d3-28d),术中、术后无严重肾出血、无输尿管穿孔、撕裂、发热等并发症。结论应用微创经皮肾镜穿刺造瘘(MPCN)、输尿管镜、尿道膀胱行钬激光碎石治疗泌尿系结石是一种安全、有效、可靠的方法,值得推广应用。
Objective To investigate the effectiveness and safety of endoscopic vitrectomy and holmium laser lithotripsy in the treatment of urinary calculi. Methods Retrospective analysis of 94 cases using nephrolithotomy, ureteroscopy, cystoscopy holmium laser lithotripsy data. Results 40 cases of kidney stones, lithotripsy time 74min (50-183min), the success rate of single gravel 89.9% (36/40), 1 case of renal failure to change the open surgery, 3 cases of stage II holmium laser lithotripsy; 46 cases of ureteral stones, gravel time 32mi (n20-57min), single gravel success rate of 100%. Bladder stones in 6 cases, 2 cases of stones due to failure of large open stone surgery, urinary tract stones in 2 cases, a gravel success. The average hospitalization days 8 (d3-28d), intraoperative and postoperative no severe renal bleeding, no perforation of the ureter, tearing, fever and other complications. Conclusion Minimally invasive percutaneous nephrolithotomy (MPCN), ureteroscopy, urethral bladder holmium laser lithotripsy is a safe, effective and reliable method, which is worth popularizing and applying.