封堵取石导管在输尿管镜碎石中的应用探讨  

Application of ureteral occlusion device in ureteroscopic lithotripsy for treatment of upper ureteral calculi

作　　者：李波[1] 李清华[1] 马克 刘骋[1] 李玉[1] 王钰[1] 姜瑞[1] 

机构地区：[1]安徽省合肥市第一人民医院(安徽医科大学第三附属医院)泌尿外科,230001

出　　处：《安徽医学》2014年第3期338-340,共3页Anhui Medical Journal

摘　　要：目的探讨运用输尿管镜碎石术配合封堵器取石导管治疗输尿管中上段结石的临床疗效及安全性。方法回顾分析2010年11月至2013年3月我院收治的42例输尿管中上段结石患者,采用输尿管镜下碎石取石方式,为防止结石上移,术中均配合使用封堵器取石导管,封堵取石导管叶片全部穿过结石位置后,将手柄往后拉形成完全封堵状态,给予气压弹道或钬激光碎石后使用封堵取石导管叶片折叠球将碎石拖入膀胱。结果成功封堵39例(92.86%),3例出现结石上移至肾脏,其中1例行经皮肾镜碎石术(PCNL),2例术后辅助行体外冲击波碎石术(ESWL)治疗,术中未发生输尿管穿孔、黏膜撕脱等严重并发症,结石总清除率为95.24%。结论封堵取石导管能有效防止输尿管镜下碎石过程中结石漂移,辅助输尿管镜治疗输尿管中上段结石具有碎石效率高、清除率高、手术时间短、住院时间短等优点。Objective To evaluate the clinical efficacy and safety of ureteral occlusion devices during ureteroscopic lithotripsy for the treatment of upper-middle ureteral calculi.Methods We reviewed the data of 42 patients who underwent ureteroscopic lithotripsy with u-reteral occlusion device for upper ureteral stones from Nov.2010 to May 2013.When the calculi were shredding up,the ureteral occlusion de-vice was extracted slightly to remove the stone fragments.Results Thirty-nine （92.86%）patients successfully occluded with stones being completely crushed once.Stone migration was found in 3 patients,2 of which were treated with ESWL and 1 of which was performed with PC-NL.There was no ureteral perforation or ureteral mucosal in all patients.The successful rate achieved 95 .24%.Conclusion The new ureter-al occlusion device was very useful and safe in preventing the stone migration,which may offer advantages with respect to diminishing residual fragments significantly,increasing the stone-free rate,reducing the operation time,and shortening postoperative hospital stay.

关 键 词：封堵取石导管 输尿管镜 输尿管中上段结石 

分 类 号：R699[医药卫生—泌尿科学] R693.4[医药卫生—外科学]