超微创时代泌尿系结石的治疗

Current treatment of urinary calculi

关键词:  经皮肾镜  输尿管镜  体外冲击波碎石

Key words:  percutaneous nephrolithotomy  retrograde intrarenal surgery  shock wave lithotripsy

摘要:

随着经皮肾镜，输尿管镜，体外冲击波碎石技术的发展，泌尿系结石的治疗进入了超微创时代。同时输尿管软镜技术让泌尿系结石的治疗方法更加多样、创伤更小，为医生提供了更多的治疗选择。在超微创时代下如何把握每种方法的适应证，规范的操作，减少并发症，并针对不同的患者选择个体化的治疗方案，是广大临床医生面临的新挑战。本文对经皮肾镜、输尿管软镜、体外冲击波碎石三种治疗手段的适应证，操作中的注意事项等进行详细评述。

Abstract:

In recent decades, there has been steady progress towards the management of urinary stones. Currently, minimally invasive procedures, including extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and retrograde intrarenal surgery (RIRS), have becomestandard treatment options in urinary calculi. Replacement of open surgery with minimally invasive techniques has reduced the morbidity, length of hospital stay and decreased the complications associated with open surgery. Various types of minimally invasive procedures in the treatment urinary stones allow tailored approach and provide more optionsfor the doctors. However, broaden knowledge in these techniques, standardized operation, avoiding complications, and personalized treatment plansare new clinical challenges.