斜仰卧截石位经皮肾镜联合输尿管镜治疗双J管滞留致全程附壁结石5例报告  

Percutaneous Nephrolithotomy Combined with Semirigid Ureteroscopic Lithotripsy in Semisupine-lithotomy Position for Encrusted Ureteral Stents:Report of 5 Cases

作　　者：葛建章[1] 傅发军[1] 刘玉明[1] 

机构地区：[1]长沙市中心医院泌尿外科,长沙410004

出　　处：《中国微创外科杂志》2017年第11期1044-1047,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨斜仰卧截石位经皮肾镜联合输尿管镜治疗双J管滞留致全程附壁结石的安全性及可行性。方法斜仰卧截石位,经尿道输尿管镜下钬激光击碎双J管膀胱段结石和输尿管内双J管附壁结石,经皮肾镜钬激光碎石术处理肾盂段双J管附壁结石和肾内新发结石。结果 5例均一期完成碎石并完整取出双J管,无一例术中改开放手术。手术时间平均65 min(40~130 min),术中无严重肾脏出血,无输尿管穿孔及撕脱。术后2例发热,无尿脓毒血症性休克发生。5例随访3~6个月,未见结石复发及输尿管狭窄形成。结论斜仰卧截石位经皮肾镜联合输尿管镜钬激光碎石术治疗双J管滞留致全程附壁结石安全、有效,值得临床推广。Objective To evaluate the safety and efficacy of percutaneous nephrolithotomy with semirigid ureteroscopic lithotripsy in semisupine-lithotomy position for treatment of encrusted ureteral stents. Methods Patients were placed in semisupinelithotomy position. The bladder stones and ureteral encrusted stones were treated with ureteroscopy,and then percutaneous holmium laser nephrolithotomy was used to break and wash out the renal pelvis stones and renal new stones. Results The stone fragmentation and stent removal were completed in one session in all 5 cases without conversion to open surgery. The mean operative time was 65 min（range,40-130 min）. No massive hemorrhage,ureteral avulsion,or ureteral perforration occurred during the operation. Two cases had postoperative fever without sepsis. No patients had ureteral stricture or recurrent calculus within follow-ups for 3-6 months.Conclusion Percutaneous nephrolithotomy combined with semirigid ureteroscopic lithotripsy in semisupine-lithotomy position for treatment of encrusted ureteral stents is safe and effective,being worthy of clinical promotion.

关 键 词：经皮肾镜取石术 输尿管镜 斜仰卧截石位 

分 类 号：R699[医药卫生—泌尿科学]