Валеология: Здоровье, Болезнь, Выздоровление. 2021; : 31-36
ОПЫТ ПРИМЕНЕНИЯ КОНТАКТНОЙ ЛАЗЕРНОЙ ЛИТОТРИПСИИ У ВОЕННОСЛУЖАЩИХ БОЛЬНЫХ ПРИ МОЧЕКАМЕННОЙ БОЛЕЗНИ
Аннотация
На базе Главного военного клинического госпиталя Министерства обороны Республики Казахстан (ГВКГ МО РК) выполнен сбор анализов результатов контактной лазерной литотрипсии, сделанной у 35 больных. Данный метод лечения оказался успешным у 99,5 % оперированных пациентов. У 2,5 % больных в послеоперационном периоде отмечены различные осложнения, самым частым из которых было обострение хронического пиелонефрита. Результаты исследования позволяют рекомендовать лазерную контактную литотрипсию в качестве метода выбора при лечении больных уролитиазом независимо от размеров и локализации конкрементов.
Список литературы
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Valeology: Health - Illnes - recovery. 2021; : 31-36
EXPERIENCE IN THE USE OF CONTACT LASER LITHOTRIPSY IN MILITARY PATIENTS WITH UROLITHIASIS
Abstract
Purpose: Improving the efficiency in the treatment of patients with urolithiasis.
Material and methods: the study involved 35 patients who underwent contact laser lithotripsy for ureteral stones. The age of the patients ranged from 18 to 55 years. Among the treated patients there were 22 (62.8 %) men and 13 (37.1 %) women. In 35 (100 %) patients, stones were localized in the ureter. The size of ureteral concretions varied from 0.5 to 1.7 cm. Single ureteral stones were detected in 25 (71.4 %) patients, multiple stones of one ureter — in 8 (22.9 %) patients and stones of both ureters-in 2 (5.7 %) patients. In the majority of patients (68 %) with single ureteral stones, concretions were located in the lower third, in 24 % - in the upper third and in 8 % - in the middle third.
Results: the recommended laser contact lithotripsy was successful in 34 (97.2%) patients, and only in 1 (2.8 %) cases it was not possible to perform it due to the presence of stenosis of the lower third of the ureter. The duration of contact lithotripsy was from 15 to 40 minutes. The period of stay of patients in the hospital when using this method of treatment ranged from 2 to 7 days. We identified certain complications of laser contact lithotripsy only in 2 (5.7 %) operated patients.
Discussion: Laser contact ureterolithotripsy is the most appropriate, low-traumatic, effective (97.2 %) method of surgical treatment for ureteral stones.
The ideal technique for contact laser ureterolithotripsy consists in advance visualization and desirable capture of the concretion basket to prevent its migration, followed by crushing and lithoextraction of fragments.
The use of contact holmium laser for ureteral stones allows to solve the main issues arising in the adequate treatment of urolithiasis, including its complications, both in the planned and emergency mode, to reduce the time of stay of patients in the hospital, to improve the quality of specialized urological care.
The result of the analysis of the surgical interventions of contact laser lithotripsy performed by us showed its highest clinical effectiveness regardless of the size and localization of the concretion. This method of treatment was successful. Thus, the data obtained by us allow us to recommend laser contact lithotripsy as a method of choice in the treatment of patients with ureteral stones and recurrent urolithiasis.
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