经尿道逆行性输尿管软镜治疗髓质海绵肾伴多发肾结石  

Retrograde flexible ureteroscopic lithotripsy formultiple renal stones secondary to medullary sponge kidney

作　　者：刘万樟 方立 谢国海[2] 袁鹤胜[2] 程跃[2] 

机构地区：[1]宁波大学医学院,浙江宁波315211 [2]宁波市第一医院泌尿外科,浙江宁波315010

出　　处：《现代泌尿外科杂志》2017年第12期930-933,共4页Journal of Modern Urology

摘　　要：目的评估经尿道逆行性输尿管软镜钬激光碎石术治疗髓质海绵肾伴多发肾结石的安全性和有效性。方法回顾性分析2014年1月至2016年1月宁波市第一医院泌尿外科收治的8例髓质海绵肾伴多发肾结石的患者。所有患者均采用逆行性输尿管软镜碎石,术后随访6~12个月,并复查腹平片(KUB)或泌尿系彩超、肾功能、尿常规和包含腰背部疼痛、泌尿系症状及自我评价分值的随访表。结果对8例患者的11侧肾结石进行碎石,平均单侧手术时间(50.8±14.6)min,术后平均住院时间(2.5±0.75)d。所有患者术后未发生严重出血、感染发热、急性腰背痛等严重并发症,均未进行输血或血制品治疗。所有患者均在术后1月左右将双J管拔除。随访中1例患者出现腰背部疼痛,余均无出现明显的腰背部疼痛、泌尿系症状和肾功能异常。其术后随访自我评价平均分值显著高于术前(6.88±0.35 vs.3.63±0.60,P<0.01)。结论经尿道逆行性输尿管软镜钬激光碎石术治疗髓质海绵肾伴多发肾结石安全、有效,尤其适用于并发输尿管结石的患者,可显著提高患者术后生活质量。Objective To evaluate the safety and efficacy of retrograde flexible ureteroscopic lithotripsy with holmium laser in the treatment of multiple renal stones secondary to medullary sponge kidney （MSK）. Methods The clinical data of 8 cases of multiple renal stones secondary to MSK treated in our department during 2014 and 2016 were retrospectively analyzed. All cases were treated with retrograde flexible ureteroscopic lithotripsy,and followed up for 6-12 months. KUB or urinary ultrasound,renal function,normal urine test and a specific questionnaire were reviewed,including flank pain, urinary tract symptoms,and self-assessment score. Results The mean operation time was （50.8 ± 14.6） min,and postoperative hospital stay was （2.5±0.75） d. No severe bleeding,infection or acute flank pain occurred after surgery,and no blood transfusion was needed. All double-J stents were removed successfully 1 month after operation. During the follow-up, flank pain happened to 1 patient. No serious complications such as obvious flank pain, urinary tract symptoms, or renal dysfunction were observed. After operation,the mean self-assessment score was significantly higher than that before operation （6.88 ±0.35） vs. （3.63 ± 0.60） （P〈 0.01）. Conclosion Retrograde flexible ureteroscopic lithotripsy with holmium laser is safe and effective to treat renal stones secondary to medullary sponge kidney.

关 键 词：髓质海绵肾 逆行性输尿管软镜碎石术 钬激光 肾多发结石 

分 类 号：R691.4[医药卫生—泌尿科学]