双J管预扩张输尿管软镜治疗肾下盏结石115例疗效分析  

Analysis of clinical effect of double J-tubes pre-expansion of ureter under flexible ureteroscope on 115 patients with lower caliceal renal calculi

作　　者：段康[1] 刘齐贵[1] 王跃力[1] 张文滔[1] 段娟[1] 

机构地区：[1]昆明医科大学附属成都军区昆明总医院泌尿外科,昆明650032

出　　处：《西南国防医药》2015年第4期389-391,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的分析双J管预扩张对输尿管软镜钬激光治疗肾下盏结石疗效的影响。方法对115例输尿管软镜联合钬激光治疗肾下盏结石的患者,术前使用双J管进行预扩张,术中观察一次性带鞘进镜成功率,术后至出院前分析碎石率、并发症发生率,出院1个月后返院拔除双J管,拔管后1个月返院复查腹部平片,评估结石排净率。结果双J管预扩张期间及术后无严重并发症发生,一次性带鞘进镜及碎石成功率100%,术中严重并发症发生率约为0.87%,拔除双J管后1个月清石率达90.4%。结论输尿管软镜治疗肾下盏结石,术前使用双J管对治疗侧输尿管进行预扩张,可提高碎石成功率和排石率。对于无禁忌证的2.5 cm以下的肾下盏结石患者,治疗上应首选双J管预扩张输尿管软镜联合钬激光碎石术。Objective To analyze the effect of double J-tubes pre-expansion of ureter flexible ureteroscope with holmium laser on 115 patients with lower caliceal renal calculi. Methods Total 115 patients with lower caliceal renal calculi were selected as research subjects and flexible ureteroscope with holmium laser was applied. Before the operation, double J-tubes were applied to pre-expansion of ureter. During the operation, the success rate with one-off lithotritization with sheath under ureteroscope was observed; during hospitalization, the lithotritization rate and complication rate were analyzed; after one month since the patients left the hospital, the J-tubes were drawn out; after one month since the tubes were drawn out, the patients were reexamined and the removal rate of calculi was evaluated on the basis of the abdominal plain film. Results During and after the double J-tubes pre-expansion of ureter, no serious complications occurred. The success rate of one-off lithotritization with sheath under ureteroscope reached up to 100%, and the incidence of intraoperative complications was about 0.87% ; after one month since the tubes were drawn out, the removal rate of calculi reached up to 90.4%. Conclusion In lithotritization of lower caliceal renal calculi under ureteroscope, preoperative double J-tubes pre-expansion of ureter may improve the success rate of lithotritization and removal rate of calculi. In lithotritization of lower caliceal renal calculi lower than 2.5 cm in patients without contraindication, double J-tubes pre-expansion of ureter under ureteroscope with holmium laser should be an optimal method.

关 键 词：预扩张 肾下盏 结石 软镜 钬激光 

分 类 号：R691.4[医药卫生—泌尿科学]