自制的输尿管软镜碎石手术辅助器械  

The self-resembled surgical devices used in retrograde intrarenal stone surgery

作　　者：来成军 熊晖 陈修德 王滕滕 LAI Chengjun;XIONG Hui;CHEN Xiude;WANG Tengteng(Department of Urology,People's Hospital of Qingyun County,Dezhou 253700;Department of Urology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]庆云县人民医院泌尿外科,山东德州253700 [2]山东第一医科大学附属省立医院泌尿外科,山东济南250021

出　　处：《现代泌尿外科杂志》2021年第1期75-79,共5页Journal of Modern Urology

基　　金：山东省医药卫生科技发展计划项目(No.2019WS480)。

摘　　要：目的利用日常生活和临床工作中常见材料自制一种软镜碎石手术用灌注设备及套石篮固定装置,介绍其初步应用于手术的实际效果。方法利用输液器及其延长管、三通旋塞阀、单向阀、注射器、负压器恒压弹簧组装成具有不同功能的灌注设备,并使用塑料广告夹组装成套石篮固定装置,在76例软镜碎石手术中实验性地使用了上述设备。结果自制的灌注设备可实现人工推注、持续灌注或负压吸引等功能的实时转换。套石篮固定装置,可实现主刀医师一人独立操作软镜及套石篮。所有患者均顺利完成手术,碎石时间为(42.4±12.8)min,套石时间为(10.6±2.8)min,注水量为(1530±660)mL。术后体温超过38.0℃者3例(3.9%),腰痛6例(7.9%)。术后3月达到结石清除标准者70例,总体清除率为92.1%。结论自制的灌注设备,灵活高效,性价比高;在固定装置辅助下,套石操作更协调,可有助于更好地完成输尿管软镜碎石手术。Objective To introduce a self-resembled flexible ureteroscopic irrigation device and stone basket holder made with some commonly used materials,and to present our initial experiences using the devices in retrograde intrarenal stone surgery.Methods We used the infusion apparatus,extension tube,three-way plug valve,Luer one-way valve,ordinary syringe,and negative-pressure spring to assemble the irrigation device with different functions.Besides,we prepared a stone basket holder with plastic billboard clips.In this study,we used these two devices experimentally in 76 stone surgeries.Results The irrigation device could do real-time conversion of manual syringe irrigation,continuous irrigation and negative-pressure suction.The stone basket holder enabled a surgeon to simultaneously manipulate the flexible ureteroscope and operate a stone extraction basket.All operations were successful.The mean lithotripsy time was(42.4±12.8)min.The mean stone extraction time was(10.6±2.8)min.The saline perfusion volume was(1530±660)mL.After operation,fever occurred in 3 cases(3.9%)with body temperature above 38.0℃and low back pain occurred in 6 cases(7.9%).After 3 months,70 patients met the stone removal criteria,and the overall stone-free rate was 9.21%.Conclusion The self-resembled irrigation device is flexible,efficient and cost-effective.The stone basket holder can improve the stone extraction.These two devices help to better complete retrograde intrarenal stone surgery.

关 键 词：输尿管软镜 输尿管软镜碎石术 灌注设备 套石篮固定装置 

分 类 号：R612[医药卫生—外科学]