电子输尿管软镜在输尿管移位到肾脏结石手术中的应用分析
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摘要
目的探讨电子输尿管软镜在输尿管移位到肾脏结石手术中的作用。方法选择2014年12月至2017年7月马鞍山市人民医院采取电子输尿管软镜处理输尿管硬镜手术移位到肾脏结石20例手术资料进行回顾性分析。6例同期处理,14例因输尿管存在狭窄扭曲行二期手术。所有病人术中均留置输尿管软镜导入鞘。结石采用钬激光碎石治疗。结果全部20例手术均顺利完成。一次性碎石成功率为90%。手术时间41～150 min,平均手术时间90 min。住院时间8～14 d,平均住院时间11.5 d。所有手术病例均无严重输尿管损伤,无严重感染情况。结论电子输尿管软镜处理输尿管上移到肾脏结石是安全有效的,值得临床推广。
Objective To evaluate the clinical value of electronic flexible ureteroscopy in the surgery of ureteral calculi translocation to kidney.Methods The data of 20 patients,who underwent electronic flexible ureteroscopic surgery of ureteral calculi translocation due to electronic rigid ureteroscopy in Ma'anshan People's Hospital from December 2014 to July 2017,were retrospectively analyzed.Electronic flexible ureteroscopy was performed simultaneously with electronic rigid one on 6 cases,while second surgery was performed on 14 others due to ureteral stenosis and distortion.Ureteric access sheath was applied and retained in each surgery.Holmium laser was used to treat the calculi.Results All of the 20 surgeries went well.The success rate of a single procedure was 90%.The operation time ranged within 41 to 150 min,and the mean time was 90 min.Hospital stay was 8 to 14 d and the mean time was 11.5 d.No serious ureter perforation or infection was found.Conclusion Electronic flexible ureteroscopy is safe and effective in treating translocated ureteral calculi,which is worthy of clinical promotion.
Objective To evaluate the clinical value of electronic flexible ureteroscopy in the surgery of ureteral calculi translocation to kidney.Methods The data of 20 patients,who underwent electronic flexible ureteroscopic surgery of ureteral calculi translocation due to electronic rigid ureteroscopy in Ma'anshan People's Hospital from December 2014 to July 2017,were retrospectively analyzed.Electronic flexible ureteroscopy was performed simultaneously with electronic rigid one on 6 cases,while second surgery was performed on 14 others due to ureteral stenosis and distortion.Ureteric access sheath was applied and retained in each surgery.Holmium laser was used to treat the calculi.Results All of the 20 surgeries went well.The success rate of a single procedure was 90%.The operation time ranged within 41 to 150 min,and the mean time was 90 min.Hospital stay was 8 to 14 d and the mean time was 11.5 d.No serious ureter perforation or infection was found.Conclusion Electronic flexible ureteroscopy is safe and effective in treating translocated ureteral calculi,which is worthy of clinical promotion.
引文
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[11] 仰光,诸禹平,肖峻,等.输尿管软镜碎石术与经皮肾镜碎石术治疗肾下盏结石的疗效对比[J].安徽医药,2016,20(3):488-491.
[12] SHVARTS O,PERRY KT,GOFF B,et al.Improved functional deflection with a dual-deflection flexible ureteroscope[J].J Endourol,2004,18(2):141-144.
[2] FISHER JD,MONAHAN M,JOHNSTON WK.Improvised method to retrieve a proximally displaced ureteral stent in a remote surgical setting[J].J Endourol,2013,27(7):922-924.
[3] ELSHEEMY MS,MAHER A,MURSI K,et al.Holmium:YAG laser ureteroscopic lithotripsy for ureteric calculi in children:predictive factors for complications and success[J].World J Urol,2014,32(4):985-990.
[4] SALVADó JA,MANDUJANO R,SAEZ I,et al.Ureteroscopic lithotripsy for distal ureteral calculi:comparative evaluation of three different lithotriptors[J].J Endourol,2012,26(4):343-346.
[5] ELASHRY OM,TAWFIK AM.Preventing stone retropulsion during intracorporeal lithotripsy[J].Nat Rev Urol,2012,9(12):691-698.
[6] DE SB,AUTORINO R,KIM FJ,et al.Percutaneous nephrolithotomy versus retrograde intrarenal surgery:a systematic review and meta-analysis[J].Eur Urol,2015,67(1):125-137.
[7] 郭和清,李建业,周高标,等.微创腔镜手术与体外冲击波碎石术治疗飞行人员上尿路结石临床疗效的对比研究[J].解放军医学杂志,2013,38(12):1015-1018.
[8] GHANI KR,SAMMON JD,BHOJANI N,et al.Trends in percutaneous nephrolithotomy use and outcomes in the United States[J].J Urol,2013,190(2):558-564.
[9] 高小峰,周铁,陈书尚,等.输尿管软镜碎石与微创经皮肾取石术治疗肾盏结石的对比研究[J].中华腔镜泌尿外科杂志(电子版),2007,1(2):69-72.DOI:10.3969/j.issn.1674-3253.2007.02.002.
[10] AUGE BK,PIETROW PK,LALLAS CD,et al.Ureteral access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation[J].Journal of Endourology,2004,18(1):33-36.
[11] 仰光,诸禹平,肖峻,等.输尿管软镜碎石术与经皮肾镜碎石术治疗肾下盏结石的疗效对比[J].安徽医药,2016,20(3):488-491.
[12] SHVARTS O,PERRY KT,GOFF B,et al.Improved functional deflection with a dual-deflection flexible ureteroscope[J].J Endourol,2004,18(2):141-144.