输尿管软镜术后输尿管石街并结石粉末堵塞输尿管支架管一例报告  

Clogging of ureteral stent by ureteral stone street and stone dust after flexible ureteroscopic lithotripsy:A case report

作　　者：孙显武 李光杰 王敏 龙寿义 罗辉玖 王士钰 陈书练 Sun Xianwu;Li Guangjie;Wang Min;Long Shouyi;Luo Huijiu;Wang Shiyu;Chen Shulian(Department of Urology,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563003,China;Department of Urology,Bozhou District People’s Hospital,Zunyi Guizhou 563100,China)

机构地区：[1]遵义医科大学附属医院泌尿外科,贵州遵义563003 [2]播州区人民医院泌尿外科,贵州播州区563100

出　　处：《遵义医科大学学报》2024年第8期811-814,共4页Journal of Zunyi Medical University

摘　　要：目的探讨输尿管软镜术后输尿管石街并结石粉末堵塞输尿管支架管致管周与管内引流不畅的临床表现及诊治方法。方法回顾性分析2022年6月遵义医科大学附属医院泌尿外科收治的1例输尿管软镜术后输尿管石街并结石粉末堵塞输尿管支架管患者的输尿管软镜术后输尿管石街并结石粉末堵塞输尿管支架管病例,并复习相关文献。结果患者以反复恶心呕吐为主要症状伴左下腹部疼痛不适,予止吐、排石、解痉等保守治疗后症状持续不缓解,经输尿管镜检查行钳夹取石及更换输尿管支架管后,呕吐及疼痛症状消失。结论当输尿管软镜术后早期出现输尿管梗阻相关症状,如剧烈恶心及呕吐、输尿管走行区疼痛不适等,同时影像学发现输尿管石街、输尿管及肾盂扩张积水时,需考虑到输尿管石街及结石粉末堵塞输尿管支架管致管周与管内引流不畅,应及时手术清除石街,更换新的输尿管支架管,改善患者症状。Objective To investigate the clinical manifestations and diagnosis and treatment of ureteral stone street with stone powder occlusion of ureteral stent tubes leading to peritubular and intratubular drainage malfunction after ureteral flexible ureteroscopy.Methods Retrospective analysis of a case of ureteral stone street with stone powder occlusion of ureteral stent tube after ureteroscopy admitted to the Department of Urology of the Affiliated Hospital of Zunyi Medical University in June,2022,combined withreview of the relevant literature.Results The patient had recurrent nausea and vomiting as the main symptom with pain and discomfort in the left lower abdomen.After conservative treatment with antiemetic,lithotripsy and antispasmodic therapy,the symptoms persisted unrelieved,and after ureteroscopy with forceps removal of the stone and replacement of the ureteral stent tube,the symptoms of vomiting and pain disappeared.Conclusion When symptoms related to ureteral obstruction,such as severe nausea and vomiting,pain and discomfort in the ureteral tract,etc.,appear in the early period after flexible ureteroscopy,and at the same time the imaging findings indicate ureteral stone street,dilated hydronephrosis of ureter and renal pelvis,it is necessary to take into account that ureteral stone street and powdered stone block the ureteral stent tube,resulting in peritubular and intraluminal drainage,and it is necessary to timely surgically remove the stone street,and replace with new ureteral stent tubes,so as to improve the patient's symptoms.

关 键 词：输尿管支架管 石街 梗阻 输尿管软镜 结石 

分 类 号：R692[医药卫生—泌尿科学]