【摘要】 目的探讨实时超声引导输尿管软镜钬激光肾盏憩室颈口内切开并碎石术治疗复杂性肾盏憩室结石的临床疗效。方法 21例复杂性肾盏憩室结石患者为研究对象,均采用实时超声引导输尿管软镜钬激光肾盏憩室口或憩室颈部内切开扩张,续行憩室结石碎石置管。观察其手术过程及疗效。结果 21例患者均成功找到肾盏憩室并行憩室颈口切开、碎石、放置双J管。18例结石完全清除(上盏憩室12例,中盏憩室6例),结石残留3例(中盏憩室1例,下盏憩室2例)。术后随访6～18个月,复发5例,其中结石残留者3例,憩室颈狭长(约1.0～1.2 cm)2例。结论实时超声引导输尿管软镜钬激光肾盏憩室颈口内切开并碎石术治疗复杂性肾盏憩室结石疗效可靠,安全便捷,有临床推广价值。更多还原

【Abstract】 Objective To discuss the clinical efficacy of real-time ultrasound-guided flexible ureteroscopic holmium laser diverticular neck incision and lithotripsy for complex caliceal diverticular calculi. Methods There were 21 patients with complex caliceal diverticular calculi as study subjects, and all were treated with real-time ultrasound-guided flexible ureteroscope holmium laser to open and dilate the diverticulum orifices or the neck of the diverticulum, and then the diverticulum stones were continued with lithotripsy and catheterization. The operation process and efficacy were observed. Results All the 21 patients successfully found the caliceal diverticulum, diverticulum neck incision, lithotripsy, and double J tube placement were completed. Calculi were completely cleared in 18 cases(12 cases of upper diverticulum, 6 cases of middle diverticulum), and calculi remained in 3 cases(1 case of middle diverticulum, 2 cases of lower diverticulum). Follow-up for 6-18 months after surgery showed 5 cases of recurrence, including 3 cases with residual calculi and 2 cases with long diverticulum neck(about 1.0-1.2 cm). Conclusion Real-time ultrasound-guided flexible ureteroscopic holmium laser diverticular neck incision and lithotripsy is reliable, safe and convenient for complex caliceal diverticular calculi, and has clinical value of promotion.更多还原