發(fā)布時間：2018-04-19 15:42

  本文選題：腎結(jié)石 + 電子輸尿管軟鏡　； 參考：《新疆醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：評價電子輸尿管軟鏡聯(lián)合鈥激光治療腎結(jié)石的臨床應(yīng)用價值,討論影響碎石成功率、結(jié)石排凈率的因素及手術(shù)操作經(jīng)驗。方法：回顧性研究于2012年3月至2013年9月在我院使用奧林巴斯電子輸尿管軟鏡聯(lián)合鈥激光治療108例腎結(jié)石患者,其中結(jié)石分布腎盂41例,腎上中盞結(jié)石52例,腎下盞結(jié)石15例。先使用F9.8輸尿管硬鏡探查患側(cè)輸尿管,置入導(dǎo)絲后留置輸尿管軟鏡鞘,引入輸尿管軟鏡,蠶食法鈥激光碎石,并使用套石籃套取出較大的結(jié)石碎屑。4周后復(fù)查KUB或雙腎CT平掃,評估結(jié)石治療效果：未排出結(jié)石碎片≥4mm者為有臨床意義的結(jié)石殘留。結(jié)果：在全部108例患者中,一次進鏡成功率93.5%(101/108)。108例軟鏡成功進鏡后,105例成功找到結(jié)石,術(shù)中尋找結(jié)石成功率97.2%(105/108),腎盂及腎上、中盞腎結(jié)石尋及率為98.9%(92/93),腎下盞結(jié)石尋及率為86.7%(13/15)；105例尋找到結(jié)石中有98例成功碎石,總碎石成功率93.3%(98/105)；下盞結(jié)石碎石成功率76.9%(10/13),中上盞及腎盂內(nèi)結(jié)石的碎石成功率95.7%(88/92),兩組之間差異有統(tǒng)計學(xué)意義(χ2=6.605,α=0.05,P0.05)�；颊咝g(shù)后1個月后來我院復(fù)查其中97例結(jié)石完全清除或殘余結(jié)石4mm,總結(jié)石排凈率88.0%(95/108)；腎盂內(nèi)及腎中上盞結(jié)石術(shù)后排凈率92.5%(86/93),腎下盞結(jié)石術(shù)后排凈率73.3%(11/15),兩者之間差異有統(tǒng)計學(xué)意義(z2=5.281,α=0.05,P0.05)結(jié)論：電子輸尿管軟鏡聯(lián)合鈥激光碎石,視野清晰,微創(chuàng)安全,是治療直徑20mm腎結(jié)石的安全有效的手段；腎盂內(nèi)及腎中上盞結(jié)石較腎下盞結(jié)石,尋及率,碎石成功率和結(jié)石術(shù)后排凈率高,有良好的臨床應(yīng)用價值。
[Abstract]:Objective: to evaluate the clinical value of electronic ureteroscopy combined with holmium laser in the treatment of renal calculi, and to discuss the factors affecting the success rate of lithotripsy, stone removal rate and operative experience.Methods: from March 2012 to September 2013, 108 patients with renal calculi were treated with Olympus electronic ureteroscope combined with holmium laser, including 41 cases of renal pelvis, 52 cases of upper calyceal stones and 15 cases of subrenal calyceal stones.The affected side ureter was examined with F9.8 ureteroscope, then the ureteral soft lens sheath was placed, the ureter soft lens was introduced, the holmium: YAG laser lithotripsy was used, and the larger stone fragments were removed with the stone basket cover. After 4 weeks, KUB or double kidney CT plain scan were reexamined.To evaluate the effect of stone treatment: those with no stone fragments 鈮，

本文編號：1773704