U-100双频双脉冲激光碎石治疗输尿管结石的临床应用-东南大学学报医学版

U-100双频双脉冲激光碎石治疗输尿管结石的临床应用

作者：梁清¹ 吴天麟¹ 王甫剑¹ 邱祥政¹ 张文达¹ 王阔兴¹ 范涛¹ 徐丹枫²

单位：1.东南大学医学院附属徐州医院,泌尿外科,江苏,徐州,221009； 2.第二军医大学长征医院,泌尿外科,上海,200003

分类号：R454.2, R693.4

出版年·卷·期（页码）：2005·24·第二期（114-115）

摘要：

目的:总结临床应用新型双频双脉冲激光碎石治疗输尿管结石的体会.方法:分析50例输尿管镜下双频双脉冲激光碎石的临床资料.结果:碎石成功43例,于术后2个月复查结石排净35例;失败7例,其中输尿管镜操作失败或碎石中发生严重输尿管穿孔损伤改开放手术3例,二期行体外震波碎石术(ESWL)治疗4例.患者术后均出现轻重不等的肉眼血尿,平均手术时间40min,激光工作时间4min,术后平均住院4 d.结论:双频双脉冲激光是一种操作简单、安全、对软组织损伤小、碎石高效的激光,但其功能单一,临床仅适用于治疗结石.其可作为对于输尿管结石不宜行ESWL治疗或ESWL治疗失败后的一种选择方法.

Objective To study and evaluate double frequency-double pulse laser (FREDDY) lithotripsy of ureteral calculi.Method 50 cases of ureteral calculi treated with FREDDY were retrospectively analyzed. Results Of 50 cases,43 were successful on the first lithotripsy. Of which in 35 cases the stone fragment completely expelled in two months. The procedure failed in 7 cases,4 cases due to up drift of calculi or incomplete lithotripsy and being transfered to ESWL therapy, 3 cases due to perforation of ureter during the procedure or failure of ureteroscopy and having received open operation ; Different degree of hematuria was seen in every case after the procedure. The average performing time was 40 minutes ,and the average time for laser exposure was 4 minutes .The patients were hospitalized after the procedure for 4 days on an average.Conclusion Easy to operate,safe and non-invasive,FREDDY is a highly efficient lithotripsy for those who failed or did not indicated ESWL.

参考文献：

[1] KOURAMBAS J, DELVECCHIO F C, PREMINGER G M. Low power holmium laser for the management of urinary tract calculi,structures,and tumors, 2001
[2] ZORCHER T, HOCHBERGER J, SCHROTT K M. In vitro study concerning the efficiency of the frequency- doubled- doublepulse Neodymium:YAG Iaser(FREDDY) for lithotripsy of calculi in the urinary tract, 1999
[3] 黄旭元, 薄隽杰, 陈斌. 双频双脉冲激光碎石治疗输尿管结石的效果. 中华泌尿外科杂志2003(10)

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