自制两端开口输尿管导管在经皮肾镜碎石术中的应用  

Application of bi-pass ureteral catheter in percutaneous nephrolithotomy

作　　者：朱明德[1] 董焱鑫[1] 高晓康[1] 杨军昌[1] 曾锐[1] 霍双进 李东[1] 尼加提[1] 

机构地区：[1]兰州军区乌鲁木齐总医院泌尿外科,新疆乌鲁木齐830000

出　　处：《现代泌尿外科杂志》2016年第2期132-134,共3页Journal of Modern Urology

摘　　要：目的探讨自制两端开口输尿管导管在经皮肾镜碎石取石术（PCNL）中的应用价值和方法。方法 2013年5月到2015年5月共86例上尿路结石患者,将F5输尿管导管盲端自侧孔处剪除,修整平滑,PCNL术中用于灌注液体制造人工肾积水,灌注美蓝及插入斑马导丝协助寻找输尿管入口（UPJ）,逆行放置安全导丝,引导斑马导丝留置双J管。结果 86例均顺利完成手术,手术时间40~120min,平均65min。无插管导致的损伤和出血。术中寻找UPJ困难者10例,6例经自制两端开口输尿管导管插入斑马导丝后循导丝找到UPJ,4例经灌注美兰后找到UPJ。无通道意外丢失。经皮肾通道顺行留置双J管困难者13例,均通过自制两端开口输尿管导管逆行置入斑马导丝引导下留置双J管成功。结论 PCNL术中采用自制两端开口输尿管导管安全、方便,能协助处理术中遇到的一些意外困难。Objective To investigate the practicality of bi-pass ureteral catheter in percutaneous nephrolithotomy（PCNL）.Methods During May 2013 and May 2015,86 patients suffered from calculus of upper urinary tract received PCNL,in which the dead end of F5 ureteral catheter was removed from the bye hole and made smooth,in order to make artificial kidney seeper,perfuse methylene blue or insert zebra thread to search ureteropelvic junction（UPJ）.Safe duct was placed retrogradely.And then the zebra thread was guided to indwell double-J stents.Results Satisfactory results were achieved in all cases without any severe complications.The operation time was 40-120 min,averaged 65 min.Of the 10 cases in which UPJ was hard to locate,6 succeeded with the help of zebra thread,and the other 4 cases succeeded by virtue of methylene blue perfusion.Of the13 cases which were hard to indwell double-J stents progradely,bi-pass ureteral catheter was used to indwell double-J stents retrogradely.Conclusion Bi-pass ureteral catheter can safely and effectively resolve some difficulties in percutaneous nephrolithotomy.

关 键 词：经皮肾镜碎石术 两端开口输尿管导管 双J管 肾结石 输尿管结石 

分 类 号：R699.21[医药卫生—泌尿科学]