输尿管软镜治疗上尿路结石十年经验总结:单中心10413例临床分析  

Ten years experience in treatment of upper urinary calculi with RIRS:clinical analysis of 10413 cases in single center

作　　者：徐桂彬[1] 李协照 何永忠[1] 杨炜青[1] 赵海波[1] 赖德辉[1] 陈金兰[1] 陈双星[1] 朱锐 李逊[1] Gui-bin Xu;Xie-zhao Li;Yong-zhong He;Wei-qing Yang;Hai-bo Zhao;De-hui Lai;Jin-lan Chen;Shuang-xing Chen;Rui Zhu;Xun Li(Department of Urology,the Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510700,China)

机构地区：[1]广州医科大学附属第五医院泌尿外科,广东广州510700

出　　处：《中国内镜杂志》2020年第6期64-68,共5页China Journal of Endoscopy

基　　金：广州医科大学高水平大学学术骨干培育计划[No:2017(210)]。

摘　　要：目的对应用输尿管软镜(RIRS)治疗上尿路结石的经验进行总结,以评价该技术的安全性及临床疗效。方法选取2007年6月-2017年6月该院采用RIRS治疗的上尿路结石患者10413例。回顾性分析可拆卸输尿管软镜(n=774)、纤维输尿管软镜(n=2293)和电子输尿管软镜(n=7346)3种软镜治疗上尿路结石的成功率、结石清除率、手术时间、住院时间和手术并发症等差异。结果可拆卸输尿管软镜、纤维输尿管软镜和电子输尿管软镜一期手术成功率分别为73.00%、82.99%和91.00%。二期手术(一期放置输尿管内支架管)分别为27.00%、17.01%和9.00%。结石清除率分别为87.00%、89.00%和93.00%。平均手术时间分别为(112.0±32.5)、(90.0±24.0)和(75.5±20.5)min。平均住院时间分别为(9.0±1.5)、(7.0±1.0)和(5.0±1.5)d。手术并发症发生率分别为3.62%、1.30%和0.99%。结论采用RIRS技术治疗上尿路结石安全、有效。随着RIRS技术的不断提高,以及输尿管软镜相关设备的不断优化,提高了该项技术的手术成功率及结石清除率、降低了并发症发生率和缩短了住院天数,RIRS治疗的临床适应证将逐步扩大。Objective To summarize the experience of retrograde intrarenal surgery(RIRS)technology in treatment of upper urinary calculi for ten years,and evaluate its safety and clinical efficacy.Methods From June 2007 to June 2017,we used RIRS to treat 10,413 patients with upper urinary calculi.774 cases were treated by removable flexible ureteroscopy,2293 cases by double-channel flexible ureteroscopy,and 7346 cases by electronic flexible ureteroscopy.Success rate,stone clearance rate,operation time,surgical complications,and length of hospital stay were analyzed respectively.Results The success rate of the first-stage operation of the three surgical methods was 73.00%,82.99%,and 91.00%,respectively.The second-stage operation(first stage placement of the D-J stent)was 27.00%,17.01%and 9.00%.respectively.The average stone free rate was 87.00%,89.00%and 93.00%,respectively.The average operation time was(112.0±32.5),(90.0±24.0)and(75.5±20.5)min,respectively.The average hospitalization time was(9.0±1.5),(7.0±1.0)and(5.0±1.5)days,respectively.The surgical complication rate was 3.62%,1.30%and 1.00%,respectively.Conclusion RIRS technology is safe,effective and reliable treatment for the upper urinary calculi.The continuous improvement and innovation of relative technology,as well as the continuous optimization of ureteroscope-related equipment,have improved the surgical success rate and stone removal rate.The data of complications and hospitalization days have been continuously reduced.It is foreseeable that the clinical indications for this technology will gradually expand.

关 键 词：上尿路结石 输尿管软镜 经验总结 安全性 临床疗效 

分 类 号：R691.4[医药卫生—泌尿科学]