后腹腔镜下输尿管切开取石联合切口冲洗治疗输尿管上段结石合并肾多发结石  

Clinical study of retroperitoneal laparoscopic ureterolithotomy combined with washing of renal pelvis through incision in the treatment of upper ureteral calculi complicated with multiple renal calculi

作　　者：周家合[1,2,3] 董洋 孙玉峰[1,2,3] 郝林 韩从辉 贺厚光[1,2,3] Zhou Jiahe;Dong Yang;Sun Yufeng;Hao Lin;Han Conghui;He Houguan(Department of Urology,Xuzhou Central Hospital,Xuzhou 221000,China;Department of Urology,Xuzhou Clinical School of Xuzhou Medical College,Xuzhou 221000,China;Department of Urology,Xuzhou Hospital Afiliated to Medical College of Southeast University,Xuzhou 221000,China)

机构地区：[1]徐州市中心医院泌尿外科,徐州221000 [2]徐州医科大学徐州临床学院泌尿外科,徐州221000 [3]东南大学医学院附属徐州医院泌尿外科,徐州1221000

出　　处：《国际泌尿系统杂志》2023年第5期818-821,共4页International Journal of Urology and Nephrology

基　　金：徐州市科技局重点研发计划(社会发展)(KC20140)。

摘　　要：目的探讨在输尿管上段结石合并多发性肾结石的治疗中,后腹腔镜下输尿管切开取石联合术中经输尿管切口行肾孟间断冲洗的可行性和安全性。方法回顾性分析2020年4月至2021年6月本院收治的采用后腹腔镜下输尿管切开取石联合术中经输尿管切口行肾盂间断冲洗治疗的18例患者的临床资料,观察患者的手术时间、手术前后血红蛋白、血肌酐、血常规白细胞、引流管留置时间、术后住院时间及结石清除率等指标。结果18例患者均完成一期手术,无中转开放手术。15例患者的一期结石清除率为100%,3例患者术后残余肾结石行体外碎石后排出。18例肾结石患者手术前后的指标比较,差异均无统计学意义(均P>0.05)。所有患者于术后3~4周在膀胱镜下拔除双J管,复查腹部平片未见结石残留,术后随访(10±4)个月,未发现肾积水加重。结论仑腹腔镜下输尿管切开取石联合术中经输尿管切口行肾孟间断冲洗治疗输尿管上段结石合并肾多发结石安全有效。Objective To investigate the feasibility and safety of retroperitoneal laparoscopic ureterolithotomy combined with intermittent irrigation of the incision renal pelvis in the treatment of upper ureteral calculi complicated with multiple renal calculi.Methods There were 18 patients were analyzed retrospectively who treated with retroperitoneal laparoscopic ureterolithotomy combined with intermittent washing of incision renal pelvis in our hospital from April 2020 to June 2021.The operation time,hemoglobin before and after operation,serum creatinine preoperative and postoperative,white blood cells preoperative and postoperativ,drainage tube retention time,postoperative hospital stay and stone clearance rate were observed.Results All the 18 cases were completed in one stage,and no conversion to open surgery was performed.The primary stone clearance rate was 100%in 15 patients,and residual kidney stones were removed after extracorporeal lithotripsy in 3 patients.There was no significant difference in the indexes of 18 patients with kidney stones before and after operation(all P>0.05).In all patients,the double-J ureteral tube was removed by cystoscope at 34 weeks after operation.No residual stones were found in abdominal plain film reexamination,and no aggravation of hydronephrosis was found after postoperative follow-up of(10±4)months.Conclusions Retroperitoneal laparoscopic ureterolithotomy combined with intermittent irrigation of renal pelvis through incision is safe and effective for some patients with upper ureteral calculi complicated with multiple renal calculi.

关 键 词：输尿管结石 肾结石 后腹腔镜输尿管切开取石术 冲洗疗法 肾盂 

分 类 号：R699[医药卫生—泌尿科学]