自制可视穿刺针式肾镜结合输尿管通道鞘治疗肾结石  

Self-made optical puncture needle combined with ureteral access sheath for renal calculi treatment

作　　者：张军晖[1] 张际青[1] 康宁[1] 关星[1] 田惠忠[1] 邱智[1] 张小东[1] 邢念增[1] 

机构地区：[1]首都医科大学附属北京朝阳医院泌尿外科,北京市100020

出　　处：《实用医学杂志》2017年第17期2896-2899,共4页The Journal of Practical Medicine

摘　　要：目的评价自制可视穿刺针结合输尿管通道鞘治疗肾结石的临床意义。方法回顾性分析2016年6月至2017年2月8例用自制可视穿刺针结合输尿管通道鞘治疗肾结石患者的临床资料。结果 8例均留置输尿管通道鞘和穿刺成功。除1例因结石移位需输尿管软镜辅助治疗外,均成功直视下碎石。结石大小为(21.9±7.3)mm、手术时间(43.6±13.6)min、术后第1天疼痛VAS评分(2.8±1.3)分、术后血红蛋白减少7.0 g/L[(143.1±12.2)g/L vs.(136.1±10.5)g/L,P>0.05]、住院时间(3.1±1.0)d。无输血患者。术后1个月无石率为87.5%(7/8),1例残留结石直径约3 mm,术后随访3个月后结石消失,术后3个月无石率为100%(8/8)。结论自制可视穿刺针结合输尿管通道鞘治疗肾结石是可行的,有利于提高术后无石率,减少PCNL相关并发症。Objective To evaluate the clinical value of a new optic puncture needle designed by our department for renal calculi treatment. Methods There were 8 patients undergoing micro-PCNL with the new device from June 2016 to February 2017. Values of basic demographic data, operation time, pain score, drop in hemoglobin and complications were recorded. Results The mean stone size, operation time, pain score, drop in hemoglobin, and in-hospital time was （21.9 ±7.3） mm, （43.6 ±13.6） min, 2.8 ± 1.3, 7.0 g/LE （ 133.2±10.3 g/L vs. （ 123.2 ± 13.9） g/L, P 〉 0.05] and （3.1 ± 1.0）d, respectively. No patient required blood transfusion. Stone-free rate at 1 and 3 months post-operation were 87.5% （7/8） and 100 % （8/8）, respectively. One suffered urinary tract infections （ Clavien I ） and was treated with antibiotics. There were no major complications. Conclusion The new device for treatment of renal calculi is feasible and effective.

关 键 词：可视穿刺针 输尿管通道鞘 肾结石 经皮肾镜取石术 斜仰卧截石位 

分 类 号：R699.2[医药卫生—泌尿科学]