输尿管软镜技术治疗“飞行员肾结石”的安全性及有效性分析  

The safty and efficiency of retrograde intrarenal surgery in the treatment of ＂Aviation Pilot renal stones＂

作　　者：李建兴[1] 肖博[2] 胡卫国[1] 杨波[2] 陈亮[2] 王晓峰[2] 

机构地区：[1]北京清华长庚医院泌尿外科,北京大学人民医院泌尿外科,北京102218 [2]北京大学国际医院泌尿外科,北京102206

出　　处：《国际泌尿系统杂志》2014年第6期795-798,共4页International Journal of Urology and Nephrology

摘　　要：目的 探讨输尿管软镜手术（Retrograde intrarenal surgery,RIRS）在治疗“飞行员肾结石”中的有效性及可行性,介绍本院处理此类结石的初步经验及体会.方法 选取2010年至2013年间于本院接受输尿管软镜治疗的“飞行员肾结石”患者32例（34侧）,其中左侧16例,右侧18例,单一结石16例,多发结石18例.患者均为男性,平均年龄25.2岁（19 -44岁）,结石平均直径5mm（3 - 11mm）,采用STORZE电子镜或经皮肾镜进行手术操作,术前1-2周留置输尿管支架管.对于术后复查有残留结石的患者采用Ⅱ期输尿管软镜或经皮肾镜取石.评估患者围手术期安全性及“净石率”等相关指标.结果 入组患者除2例患者接受经皮肾镜治疗外,其余均顺利完成输尿管软镜碎石取石术.平均手术时间56min（30 - 135min）,术后平均住院时间2.8d（1-10d）.其中29例患者Ⅰ期输尿管软镜取净结石,3例患者行Ⅱ期输尿管软镜碎石术,1例患者Ⅱ期术后仍有残留接受了经皮肾镜手术,1例患者直接采用经皮肾镜手术.入组患者术后复查泌尿系CT均未见结石残留,总体净石率97％,软镜碎石率94％.结论 输尿管软镜术治疗“飞行员肾结石”安全性高,手术效果确切,可以作为此类结石的首选治疗方式.Objectives To investigate the efficiency and feasibility of retrograde intrarenal surgery （RIRS） for treatment of avation pilot renal stones.Introduce the initial experience to due with this kind of case in our center.Methods 32 cases（34 sides）of ＂pilot renal stones＂ were treated with RIRS during 2010 and 2013.Right 16 cases and 18 cases left.16 cases of single stone and 18 cases of multi stones.Patients are all male,with average age of 25.2 years old（range from 19 to 44）.Maximum diameter was 5mm（Range from 3mm to 11mm）.Operations were performed under electron microscopy （STORZE） or percutaneous nephrolithotripsy（PCNL）.Ureteral stent was placed one week before surgery.For residual stones,two-stage RIRS and/or PCNL were choosed.The safety,stone clearence rate and perioperative parameters were evaluated.Results Patients were all underwent RIRS successfully except 2 cases of PCNL.Mean operative time was 56min（Range from 30 to 135mins）,Postoperative incharge days were 2.8 （Range from 1 to 10）.29 cases received one stage operation and 3 cases two-stage.PCNL was performed in two patient finally.Postoperative computed tomography was performed.The general stone-free rate was 97％,and the rate of RIRS was 94％.Conclusions Retrograde intrarenal lithotomy for pilot kidney stones is safe,with definite efficiency.This technique can be used as the first therapy to due with this kind of stones.

关 键 词：肾结石 输尿管镜检查 碎石术 

分 类 号：R856[医药卫生—航空、航天与航海医学]