自制气囊杆扩张器在后腹腔镜上段输尿管切开取石术中的应用分析  

Clinical analysis of retroperitoneal laparoscopic ureterolithotomy using home-made air balloon tube dilator

作　　者：梁志强 吴杰英[2] 洪家文 李辽源[2] 司徒杰[2] 

机构地区：[1]广东省阳江市阳东县人民医院泌尿外科,529900 [2]中山大学附属第三医院泌尿外科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2012年第5期42-44,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨一种新的自制气囊杆扩张器在后腹腔镜上段输尿管切开取石术中的应用价值。方法患者均接受后腹腔镜输尿管切开取石术,其中采用自制气囊杆扩张器建立后腹腔操作空间96例,采用传统气囊扩张法建立后腹腔操作空间103例,对比分析两组后腹腔空间建立时间、手术时间、术中失血量、首个穿刺道漏气率(A点漏气率)、首个穿刺道渗血率(A点渗血率)、腹膜穿破率、术后并发症发生率以及术后住院天数等数据。结果自制气囊杆组在建立操作空间时间、A点漏气率、A点渗血率、术中出血量、手术时间、术后住院时间及术后镇痛时间方面均少于传统气囊组(P<0.05),而在腹膜穿破发生率、结石取净率及术后并发症发生率方面两组之间无明显的差异(P>0.05)。所有患者术后随访2～13个月,无输尿管狭窄或结石复发。结论经自制气囊杆扩张器建立后腹腔操作空间能提高手术效率并降低术中出血风险,临床应用有效、可靠,具有推广价值。Objective To evaluate the clinical efficacy and value of a new homemade air balloon tube dilator in retroperitoneal laparoscopic ureterolithotomy. Methods Chnical data of 96 cases treated by homemade air balloon tube dilator and 103 cases treated by common air balloon dilator were analyzed retrospectively. Clinical data such as retroperitoneal space establishing time, operative time, blood loss, air leakage rate of the first 10 mm Trocar （A-point）, and complication rate were evaluated. Results Retroperitoneal space establishing time, air leakage and bleeding rate of A-point, operative time, and postoperative hospitalization duration were improved in cases treated using home-made air balloon tube dilator than those using common air balloon dilator （P〈0.05）. There were no significant difference between two groups in incidence of peritoneum rupture, stone clearance rate and postoperative complication rate （P〉 0.05）. After 2-13 months of follow-up, no ureter stricture and stone recurrence were observed. Condusious The application of this new home-made air balloon tube dilator car/improve clinical efficacy and reduce bleeding risk during retroperitoneal laparoscopic ureterolithotomy. It deserve to be promoted widelly.

关 键 词：腹腔镜 输尿管切开取石术 自制 气囊杆扩张器 

分 类 号：R699[医药卫生—泌尿科学]