输尿管软硬镜联合一期治疗89例输尿管上段结石及肾结石的可行性  

The feasibility of ureteroscope combined with flexible ureteroscope to treat 89 cases of proximal ureteral calculi and renal calculi in the first stage

作　　者：曹靖[1] 陈文军[1] 叶张丹 刘杰[1] 孙桢[1] 毛林华 CAO Jing CHEN Wen-jun YE Zhang-dan LIU Jie SUN Zhen MAO Lin-hua(Department of Urology, Hangzhou Hospital of Chinese People＇s Armed Police Forces, Hangzhou 310051, China)

机构地区：[1]武警浙江总队杭州医院泌尿外科,浙江杭州310051

出　　处：《现代泌尿外科杂志》2017年第1期44-47,共4页Journal of Modern Urology

摘　　要：目的探讨输尿管软硬镜联合一期治疗输尿管上段结石及肾结石的安全性、可行性及临床疗效。方法回顾性分析2012年12月至2015年12月本院89例输尿管上段结石及肾结石患者一期行输尿管软硬镜联合碎石取石术的临床资料。采用CT检测分析术后结石清除率,明确碎石效果。残石≥3mm为有意义残石,术后行体外冲击波碎石术。结果 89例患者均一期完成手术。手术时间(76±19)(50~138)min,其中输尿管软镜时间(58±13)(37~104)min;结石长径(1.6±0.5)(0.8~2.5)cm。术后2周复查KUB并拔除双J管。术后4周复查CT:结石排净83例(碎石成功率93.3%);6例术后残留结石(≥3mm),结合体外冲击波碎石术,术后2周结石完全排净。术后15例出现全身炎症反应综合征(SIRS),加强抗感染及激素冲击治疗后,感染得到控制。结论输尿管软硬镜联合一期治疗输尿管上段结石及肾结石安全有效,可显著提高碎石清除率。Objective To assess the safety, feasibility and clinical efficacy of the combination of ureteroscope and flexible ureteroscope to treat proximal ureteral calculi and renal calculi. Methods The clinical data of 89 patients who underwent combined ureteroscope and flexible ureteroscope to treat proximal ureteral calculi and renal calculi during Dec. 2012 and Dec. 2015 were retrospectively analyzed. All patients received CT test after the operation to analyze the stone free rate （SFR）. Residual stones greater than 3 mm were considered meaningful, which were then treated with extracorporeal shock wave lithotripsy （ESWL）. Results All 89 cases were successful in the first stage. The operation time was 50-138（mean 76）min. Flexible ureteroscope was used for 37-104 （mean 58）min. The stone size was 0.8-2.5 （mean 1.6）cm. The SFR was 93.3 % （83/89） 4 weeks after the operation. Residual stones in the other 6 cases were removed with ESWL 2 weeks later. Systemic inflammatory response syndrome （SIRS） occurred in 15 cases after the operation, which was controlled by antibiotics and hormonal drugs. Gonclusions The combination of ureteroscope and flexible ureteroscope is safe and effective in the treatment of proximal ureteral calculi and renal calculi. It can greatly increase the SFR.

关 键 词：输尿管镜 一期 输尿管结石 碎石取石术 

分 类 号：R692.4[医药卫生—泌尿科学] R693.4[医药卫生—外科学]