目的：评价新型组合式输尿管软镜联合钬激光治疗肾结石的临床疗效。方法：应用德国铂立组合式输尿管软镜联合钬激光治疗肾结石患者40例，观察其疗效，并与同期一体式输尿管软镜治疗的40例肾结石患者进行比较。结果：应用新型组合式输尿管软镜治疗的40例肾结石患者中，37例患者碎石成功，手术时间为（86．0±34．4）min，术后住院时间为（5．3±1．6）d。均未出现术中严重出血、输尿管穿孔、术后高热等并发症。术后1个月行KUB及B超检查显示35例结石完全清除，2例患者残留肾盏结石4 mm，药物治疗及体位引流，2周后行KUB及B超，显示结石已排出。组合式输尿管软镜组与一体式输尿管软镜组间结石大小、结石清除率、并发症发生率、手术时间、术后住院时间差异均无统计学意义（P ＞0．05）。结论：新型组合式输尿管软镜手术治疗肾结石安全、疗效确切，可以取得与传统一体式输尿管软镜相同的手术效果，并改进了传统输尿管软镜维修费用昂贵的缺点。%Objective To evaluate the effectiveness of a newly designed modular flexible ureteroscope with holmium laser lithotripsy for the treatment of renal calculi based. Methods 40 patients were treated with modular flexible ureteroscopic lithotripsy (German Polydiagnost) with holmium laser. 40 patients were treated by traditional flexible ureteroscopic lithotripsy. Their therapeutic effects were compared. Results For modular flexible ureteroscopic lithotripsy group, 37 patients underwent successful operation, with lithotripsy with operation time of (86.0 ± 34.4) min and postoperative hospital stay of (5.3 ± 1.6) days. No severe complication including ureteral perforation, high fever or severe bleeding occurred. One month after the operation, KUB and B-ultrasonography showed complete stone free in 35 patients. Residual calculi (0. 4 cm in diameter) in the calyces were found in 2 patients. Medication and postural drainage therapy were applied. Two weeks later , KUB and B-ultrasonography showed that the residual stones have been removed completely. There was no significant differences in stone size , operation time, rate of calculus clearance, the incidence of postoperative complications, operating time and duration of postoperative hospitalization between the traditional flexible ureteroscopic lithotripsy group and modular ureteroscopic lithotripsy group. Conclusions The modular flexible ureteroscope is effective and safe in treating reanl calculi. It has similar surgical efficacy as traditional flexible ureteroscope , but is more costly effective in terms of maintenance costs.
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