外置输尿管导管的无管化微通道经皮肾镜取石术(附21例报告)  

External Ureteral Catheterization of Tubeless Mini-percutaneous Nephrolithotomy:Report of 21 Cases

作　　者：陶水祥[1] 詹传传 高珂 张浩杰 任煜[1] 沈翀[1] 王少波[1] 应向荣[1] 阎家骏[1] Tao Shuixiang;Zhan Chuanchuan;Gao Ke(Department of Urology,Shaoxing People’s Hospital,Shaoxing 312000,China)

机构地区：[1]浙江省绍兴市人民医院泌尿外科,绍兴312000

出　　处：《中国微创外科杂志》2023年第12期950-953,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的评价外置输尿管导管的无管化微通道经皮肾镜取石术(mini-percutaneous nephrolithotomy,mini-PCNL)治疗单发泌尿系结石的有效性、安全性。方法回顾性分析2021年6月~2022年12月无管化mini-PCNL治疗21例单发肾、输尿管上段结石的资料。肾结石16例,输尿管上段结石5例,结石长径1.5~3.5 cm,(2.07±0.56)cm。先经膀胱镜留置输尿管导管后留置导尿,并将输尿管导管和导尿管固定,行mini-PCNL后无残留结石,则撤除Peel-away鞘,缝合切口。结果手术均顺利完成,术后3~5 d拔除导尿管及输尿管导管后出院。术后均有轻微肉眼血尿,发热3例,肾周血肿4例,无尿外渗。出院后1个月复查B超或CT平扫,未见结石,肾周无尿囊肿和血肿形成。结论对于经过选择的病例(单发,非鹿角形结石,术中无结石残留,无输尿管狭窄),外置输尿管导管无管化mini-PCNL安全有效。Objective To evaluate the efficacy and safety of external ureteral catheterization of tubeless mini-percutaneous nephrolithotomy(mini-PCNL)in the treatment of single urinary calculus.Methods Clinical data of 21 patients with single renal or upper ureteral calculi treated with tubeless mini-PCNL from June 2021 to December 2022 were retrospectively analyzed.Among them,there were 16 cases of kidney stones and 5 cases of upper ureteral stones.The length of stones was 1.5-3.5 cm(mean,2.07±0.56 cm).The ureteral catheter was indwelled by cystoscope and retained for catheterization,and the ureteral catheter and catheterization were fixed.If there were no residual stones after mini-PCNL,the Peel-away sheath was removed and the incision was sutured.Results All the operations were successfully completed,and the catheterization and ureteral catheter were removed 3-5 days after operation.There were slight gross hematuria in all the cases,fever in 3 cases,perirenal hematoma in 4 cases,and no urinary extravasation postoperatively.One month after discharge,B-ultrasonography or CT scanning showed no lithiasis,urinary cyst or hematoma formation around the kidney.Conclusion In selected cases(single and non-staghorn stones,without intraoperative stone residue or ureteral stenosis),external ureteral catheterization of tubeless mini-PCNL is safe and effective.

关 键 词：外置输尿管导管 无管化 经皮肾镜术 单发结石 

分 类 号：R699.2[医药卫生—泌尿科学]