一次性输尿管软镜在一期输尿管软镜碎石中的应用  

Application of disposable flexible ureteroscope in primary ureteral lithotrips

作　　者：张开能 奎梦霞 王斌 麦啸 柯昌兴[2] 赵金治 Zhang Kaineng;Kui Mengxia;Wang Bin;Mai Xiao;Ke Changxing;Zhao Jinzhi(Department of Urology,Dali people's Hospital,Yunnan,Dali 67100,China 2Department of Urology,The Second Affiliated Hospital of Kunming Medical University,Yunnan,Kunming 650000,Chin)

机构地区：[1]大理白族自治州人民医院泌尿外科,云南大理671000 [2]昆明医科大学第二附属医院泌尿外科,云南昆明650000

出　　处：《青岛医药卫生》2024年第6期420-423,共4页Qingdao Medical Journal

基　　金：云南省“高层次人才培养支持计划”名医专项(YNWR-MY-2020-055);大理大学教育教学改革项目(JG09YX214)。

摘　　要：目的 总结国产一次性电子输尿管软镜在一期输尿管软镜治疗肾或输尿管上段结石的应用。方法 收集2022年9~11月大理白族自治州人民医院泌尿外科100例肾或输尿管上段结石患者,采用国产一次性电子输尿管软镜治疗的临床资料,包括手术时间、碎石时间、术后住院日、术后清石率、视觉模拟量表(VAS)评分、舒适度评分标准(BCS)评分、并发症等进行分析。术中置入F11/13或F12/14输尿管软镜鞘,采用365μm激光光纤配合钬激光碎石,术后常规留置双J管并导尿。结果 94例患者顺利完成碎石,6例患者因输尿管狭窄无法置入输尿管软镜鞘而未能碎石,仅留置输尿管支架管。手术时间30~80min,(48.02±12.53) min;钬激光碎石时间18~65min (37.54±9.83) min;术后住院日1~6d,(2.24±0.94)d;术后感染2例(2.0%);VAS评分(1.86±1.05)、BCS评分(1.74±0.44)、术后1个月清石率85.1%(80/94)、术后3个月清石率96.8%(91/94)。1例肾结石患者术后出现“石街”,2例患者肾下盏盏颈细长、IPA角较小软镜无法完全进入,未能完全碎石。结论 国产一次性电子输尿管软镜一期治疗肾、输尿管上段结石(直径<2 cm)是一种微创、安全、有效的方法。Objective To summarize the application of domestic disposable electronic ureteroscope in the primary treatment of renal or upper ureteral calculi.Methods From September to November 2022,clinical data from 100 patients with renal or upper ureteral stones treated at the Urology Department of Dali Bai Autonomous Prefecture People's Hospital were collected.These patients were treated with domestically produced disposable electronic flexible ureteroscopes.The analysis included surgical time,stone fragmentation time,postoperative hospital stay,postoperative stone clearance rate,Visual Analogue Scale(VAS)score,Comfort Criteria Scale(BCS)score,and complications.The ureteral soft lens sheath of F11hammer 13 or F12Compact 14 was implanted during the operation,and 365μm laser optical fiber combined with holmium laser lithotripsy was used.Double J tubes and urinary catheterization were routinely placed after operation.Results Lithotripsy was successfully completed in 94 patients,and ureteral stent was retained in 6 patients because ureteral stricture could not be inserted into ureteroscope sheath and lithotripsy failure.Operation time was 30~80min(48.02±12.53)min;holmium laser lithotripsy time was 18~65min (37.54 ±9.83) min;postoperative hospital stayed 1 to 6 d(2.24 ±0.94) d, postoperative infection in 2 cases (2.0%), VAS score was (1.86 ±1.05), BCS score was (1.74 ±0.44), The stone clearance rate was 85.1% (80/94) one month after surgery and 96.8% (91/ 94) three months after surgery. One patient with renal calculi appeared "stone street" after oper-ation. In 2 patients, the infrarenal calyx neck was slender and the IPA angle was small,so soft lens could not completely enteredand lithotripsy failure. Conclusion Domestic disposable elec-tronic ureteroscope is a minimally invasive, safe and effective method for one-stage treatment of renal and upper ureteral calculi (diameter < 2cm).

关 键 词：一次性输尿管软镜 一期碎石 肾输尿管上段结石 

分 类 号：R692.4[医药卫生—泌尿科学]