末端可弯输尿管吸引鞘联合输尿管软镜在上尿路结石中的应用  

Application of Flexible Terminal Suction Ureteral Access Sheath Combined With Flexible Ureteroscope for Upper Urinary Calculi

作　　者：张兆林[1] 谢天朋[1] 江波[1] 刘佛林[1] 肖日海[1] 袁源湖[1] 邹晓峰[1] 李方志 冷松 钟秉琨 赖小兵 王晓宁[1] Zhang Zhaolin;Xie Tianpeng;Jiang Bo(Department of Urology,First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院泌尿外科,赣州341000 [2]赣南医学院第一临床医学院,赣州341000 [3]江西省赣州市寻乌县中医院外科,赣州342200 [4]江西省赣州市寻乌县人民医院泌尿外科,赣州342200

出　　处：《中国微创外科杂志》2023年第8期581-586,共6页Chinese Journal of Minimally Invasive Surgery

基　　金：江西省教育厅青年项目(190819);江西省卫生健康委项目(202210893);赣州市科技局指导项目(GZ2019ZSF051)。

摘　　要：目的探讨末端可弯输尿管吸引鞘联合输尿管软镜治疗上尿路结石的安全性和有效性。方法回顾性分析2022年2~8月采用末端可弯输尿管吸引鞘联合输尿管软镜治疗75例上尿路结石的资料。肾结石57例,输尿管上段结石12例,肾结石合并输尿管上段结石6例。左侧31例,右侧36例,双侧8例。结石长径(18.7±5.2)mm,CT值(1052.4±288.6)HU。结果75例手术均顺利,术中均未发生严重并发症。手术时间(58.6±13.6)min,术后住院时间(2.9±1.0)d。术后第1天结石清除率86.7%(65/75),术后30天结石清除率93.3%(70/75)。术后并发症5例,包括感染性休克1例,发热3例,血尿1例,均治愈。结论末端可弯输尿管吸引鞘联合输尿管软镜治疗上尿路结石安全、可行,疗效确切。Objective To probe the effectiveness and safety of flexible terminal suction ureteral access sheath combined with flexible ureteroscope for upper urinary calculi.Methods A retrospective analysis was performed on 75 patients treated with flexible terminal suction ureteral access sheath combined with flexible ureteroscope for upper urinary calculi from February 2022 to August 2022.There were 57 patients with renal calculi,12 patients with upper ureteral calculi,and 6 patients with renal and upper ureteral calculi,with 31 cases on the left,36 cases on the right,and 8 cases on both sides.The mean stone size was(18.7±5.2)mm and the mean stone CT value was(1052.4±288.6)HU.Results The operations were successful in all the 75 cases without intraoperative complications.The mean operation time was(58.6±13.6)min,and the mean postoperative hospital stay was(2.9±1.0)days.The stone free rate 1 day and 30 days postoperatively was 86.7%(65/75)and 93.3%(70/75),respectively.Postoperative complications occurred in 5 patients,including septic shock in 1 case,fever in 3 cases,and hematuria in 1 case.All the patients with complications recovered and discharged after appropriate treated.Conclusion Flexible terminal suction ureteral access sheath combined with flexible ureteroscope for upper urinary calculi is safe and effective,having a definite therapeutic effect.

关 键 词：输尿管软镜 输尿管鞘 上尿路结石 

分 类 号：R699[医药卫生—泌尿科学]