中文摘要：

目的探讨输尿管软镜钬激光碎石术治疗长径≥2 cm肾结石的有效性和安全性。方法回顾性分析2014年3月至2015年8月采用输尿管软镜钬激光碎石术治疗68例长径≥2 cm肾结石患者的临床资料。评估一次性结石清除率及并发症等情况。结果一次进镜成功率100%,结石寻及率为100%,总的一次性结石清除率为86.76%。其中长径2～3 cm组一次性结石清除率为90.90%,长径≥3 cm组一次性结石清除率为69.20%。总的并发症发生率为7.35%。其中长径2～3 cm组并发症发生率为7.27%,长径≥3 cm组并发症的发生率为7.69%。术中损伤出血1例,保守治疗后好转。术后石街形成2例,急诊手术治疗结石成功清除。术后发热4例,其中2例为石街形成所致,急诊手术治疗后好转,另2例经抗感染治疗好转,无严重出血及感染性休克等严重并发症发生。结论输尿管软镜碎石术治疗长径≥2 cm肾结石安全有效,是除经皮肾镜碎石术之外的又一选择。

英文摘要：

Objective To evaluate the safety and curative efficacy of flexible ureteroscopy （FURS） with holmium laser lithotripsy in the treatment of renal stones of 2 cm or greater in length-diameter. Methods A total of 68 patients who had the renal calculi of 2 cm or greater in length-diameter were treated with FURS in our department from March 2014 to August 2015 were enrolled in this study. The stone-free rates after 1 procedure, and complications were collected and retrospectively analyzed. Results The one-time successful rate of ureteroscopic insertion was 100%, and the successful rate of stone finding was 100%. After 1 procedure, the percentage of stone-free patients was 86.76%, and the stone-free rate was 90.9% for those with stones of 2 - 3 cm in size, and 69.20% for those with stones 〉 3 cm. The total complication rate was 7.35%, and was 7.27% and 7.69% respectively for those with stones of 2 ~3 cm, and 〉3 cm. One case had renal hemorrhage during operation and was improved after conservative treatment. Two cases occurred post-operative ureteral stone street, and the stones were removed successful after emergency operation. Post- operative fever occurred in 4 cases. Two of them were due to ureteral stone street and were improved after emergency operation, and the other 2 cases with fever were improved after anti-infective therapy. No severe complication happened, such as severe hemorrhage and septic shock in all the cases. Conclusion FURS with holmium laser lithotripsy is another favorable option for eligible patient and experienced urologists in treatment of renal stones of over 2 cm in size.