[1]孟玺①蒋晓峰①金铭①张伟忠①吕代兵①杨江华程代川孟繁超高国静李云智②廖晓星**.可弯曲负压吸引鞘与常规鞘输尿管软镜碎石术一期治疗肾下盏结石的疗效比较[J].中国微创外科杂志,2026,01(5):278-283.
　Meng Xi,Jiang Xiaofeng,Jin Ming,et al.Comparison of Efficacy of Flexible Ureteroscopy Combined With Flexible Vacuum Suction Ureteral Access Sheath and Conventional Sheath Flexible Ureteroscopy in the Treatment of Lower Calyceal Calculi[J].Chinese Journal of Minimally Invasive Surgery,2026,01(5):278-283.
点击复制

可弯曲负压吸引鞘与常规鞘输尿管软镜碎石术一期治疗肾下盏结石的疗效比较()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2026年5期
页码:
278-283
栏目:
临床研究
出版日期:
2026-05-21

文章信息/Info

Title:
Comparison of Efficacy of Flexible Ureteroscopy Combined With Flexible Vacuum Suction Ureteral Access Sheath and Conventional Sheath Flexible Ureteroscopy in the Treatment of Lower Calyceal Calculi
作者:
孟玺①蒋晓峰①金铭①张伟忠①吕代兵①杨江华程代川孟繁超高国静李云智②廖晓星**
(北京中医药大学第三附属医院泌尿外科，北京100029)
Author(s):
Meng Xi;  Jiang Xiaofeng;  Jin Ming;  et al.
Department of Urology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China
关键词:
肾下盏结石; 可弯曲负压吸引鞘; 输尿管软镜碎石术; 结石清除率
Keywords:
Lower calyceal calculi; Flexible vacuum suction ureteral access sheath; Flexible ureteroscopic lithotripsy; Stone clearance rate
文献标志码:
A
摘要:
目的探讨输尿管软镜联合可弯曲负压吸引鞘（flexible vacuum suction ureteral access sheath，FVSUAS）一期治疗肾下盏结石的临床效果。方法回顾性比较2022年1月～2025年2月一期输尿管软镜碎石术(retrograde intrarenal surgery, RIRS)联合FVSUAS治疗肾下盏结石49例(观察组)与RIRS术中使用常规输尿管鞘治疗肾下盏结石53例(对照组)的临床资料，比较2组手术时间，术后3 d和4周结石清除率，术后4周血尿、疼痛、发热等并发症和术后4周患者满意度等。结果观察组手术时间(59.9±21.9)min,明显短于对照组(97.9±26.0)min(t=-7.935，P=0.000)；观察组术后3 d、1个月结石清除率均显著高于对照组(χ2=7.193，P=0007； χ2=7.836， P=0.005)。观察组术后1个月疼痛发生率显著低于对照组(χ2=4.169，P=0.041)，术后血尿、发热发生率与对照组比较差异均无统计意义(χ2=1.923，P=0.166； χ2=0.844，P=0358)。观察组术后4周患者满意率显著高于对照组(χ2=5290，P=0.021)。结论输尿管软镜联合FVSUAS治疗肾下盏结石能够缩短手术时间，提高一期手术结石清除率，患者满意度高，值得临床推广应用。
Abstract:
ObjectiveTo explore the clinical efficacy of onestage flexible ureteroscopy combined with flexible vacuum suction ureteral access sheath （FVSUAS） in the treatment of lower calyceal calculi.MethodsFrom January 2022 to February 2025, our department performed retrograde intrarenal surgery (RIRS) combined with FVSUAS in the treatment of 49 cases of lower calyceal calculi (observation group), and compared them with 53 cases of lower calyceal calculi treated by using conventional ureteral sheath in the same period (control group). The operation time, stone clearance rates at 3 d and 4 weeks after surgery, complications such as hematuria, pain, fever at 4 weeks after surgery, and patient satisfaction after 4 weeks were compared between the two groups.ResultsThe operation time of the observation group was (59.9±21.9) min, significantly shorter than that of the control group ［(97.9±26.0) min, t=-7.935, P=0.000］. The stone clearance rates of the observation group at 3 d and 4 weeks after surgery were higher than those of the control group (χ2=7.193, P=0.007; χ2=7.836, P=0.005). The incidence of pain at 1 month after surgery in the observation group was significantly lower than that in the control group (χ2=4.169, P=0041), and the incidences of hematuria and fever after surgery of the observation group showed no statistically significant differences compared with the control group (χ2=1.923, P=0.166; χ2=0.844, P=0.358). The patient satisfaction rate of the observation group at 4 weeks after surgery was higher than that of the control group (χ2=5.290, P=0.021).ConclusionsFlexible ureteroscopy combined with FVSUAS in the treatment of lower calyceal calculi can shorten the operation time, improve the stone clearance rate of the first stage operation, and has a high patient satisfaction rate. It is worthy of clinical application and promotion.

参考文献/References:

[1]Kayar K, Kayar R, Tuncel KG, et al. Stonefree rate after RIRS: A multivariable analysis and predictive nomogram from a singlecenter study. World J Urol,2025,43(1):369.
[2]徐汉江,郝宗耀,曾国华,等.肾下盏解剖结构对输尿管软镜碎石术疗效影响的研究进展.临床泌尿外科杂志,2018,33(2):129-131.
[3]Stamatelou K, Goldfarb DS. Epidemiology of kidne stones. Healthcare(Basel),2023,11(3):424.
[4]泌尿系结石诊断治疗指南.见：黄健,张旭,主编.中国泌尿外科和男科疾病诊断治疗指南.北京：科学出版社,2022.392-393.
[5]Tzelves L, Geraghty R, Lombardo R, et al. Duration of followup and timing of discharge from imaging followup, in adult patients with urolithiasis after surgical or medical intervention: A systematic review and metaanalysis from the European Association of Urology Guideline Panel on urolithiasis. Eur Urol Focus,2023,9(1):188-198.
[6]李长凤,周小荣,彭杨洋,等.针对性护理对肾结石钬激光碎石术围手术期患者满意度的影响.泌尿外科杂志(电子版),2024,16(1):73-77.
[7]杨嗣星,廖文彪,宋超,等.湖北省尿路结石患者的临床流行病学调查.中华泌尿外科杂志,2018,39(9):647-650.
[8]蒋晓峰,李云智,金铭,等.输尿管软镜碎石术联合可弯曲负压吸引鞘术后无管化治疗>2 cm上尿路结石的疗效观察.江苏大学学报(医学版),2024,34(4):301-306.
[9]张兆林,谢天朋,江波,等.末端可弯输尿管吸引鞘联合输尿管软镜在上尿路结石中的应用.中国微创外科杂志,2023,23(8):581-586.
[10]Zeng G, Traxer O, Zhong W, et al. International Alliance of Urolithiasis guideline on retrograde intrarenal surgery. BJU Int,2023,131(2):153-164.
[11Giulioni C, Fuligni D, Brocca C, et al. Information technologyopen systems interconnection-Part 2: Interconnection protocols. Int J Braz Urol,2024,50(4):459-469.
[12]殷金成,刘洪新,顾燕青,等.输尿管软镜碎石术治疗直径2～3cm肾结石对病人肾功能及炎性因子水平的影响.临床外科杂志,2023,31(2):133-136.
[13]李尧,李权,何奇瑞,等.输尿管软镜下钬激光碎石术后输尿管石街形成的处理时机.中国微创外科杂志,2020,20(1):39-41.
[14]黄翻,白大应,刘杰,等.输尿管软镜碎石术后输尿管石街46例治疗体会.现代泌尿外科杂志,2022,27(2):130-132.
[15]王俊,郭志新,杨登科,等.可视穿刺联合超微通道经皮肾镜取石术治疗IPA<30°肾下盏结石的临床研究.临床泌尿外科杂志,2021,36(11):867-871.
[16]Tao W, Ming X, Zang Y, et al. The clinical outcomes of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi. J Xray Sci Technol,2022,30(1):123-133.
[17]Inoue T, Murota T, Okada S, et al. Influence of pelvicaliceal anatomy on stone clearance after flexible ureteroscopy and holmium laser lithotripsy for large renal stones. J Endourol,2015,29(9):998-1005.
[18]Karim SS, Hanna L, Geraghty R, et al. Role of pelvicalyceal anatomy in the outcomes of retrograde intrarenal surgery (RIRS) for lower pole stones: outcomes with a systematic review of literature. Urolithiasis,2020,48(3):263-270.
[19]沈宸,范博,李先承,等.输尿管软镜钬激光碎石术治疗肾下盏结石的有效性分析.临床泌尿外科杂志,2021,36(8):622-626.
[20]李云智,蒋晓峰,金铭,等.输尿管软镜碎石术治疗累计直径>2 cm上尿路结石一期清石率影响因素及预测模型建立.中华腔镜泌尿外科杂志(电子版),2024,18(1):58-63.
[21]Shrestha A, Adhikari B, Panthier F, et al. Flexible ureteroscopy for lower pole calculus: is it still a challenge? World J Urol,2023,41(11):3345-3353.
[22]Resorlu B, Oguz U, Resorlu EB, et al. The impact of pelvicaliceal anatomy on the success of retrograde intrarenal surgery in patients with lower pole renal stones. Urology,2012,79(1):61-66.
[23]Fink HA, Wilt TJ, Eidman KE, et al. Medical management to prevent recurrent nephrolithiasis in adults: A systematic review for an American College of Physicians clinical guideline. Ann Intern Med,2013,158(7):535-543.
[24]Geavlete B, Mare?瘙塂 C, Mul?瘙塅escu R, et al. Hybrid flexible ureteroscopy strategy in the management of renal stonesa narrative review. J Med Life,2022,15(8):919-926.
[25]中华医学会泌尿外科学分会结石学组,中国泌尿系结石联盟.负压技术在输尿管镜治疗上尿路结石应用的中国专家共识(2023年).临床泌尿外科杂志,2023,38(8):565-568.
[26]王杜渐,唐庆来,柳发德,等.可弯曲负压吸引鞘联合一次性输尿管软镜治疗1～2 cm肾下盏结石的疗效.现代泌尿外科杂志,2025,30(1):29-33.
[27]李武学,许长宝,赵兴华,等.一次性输尿管软镜应用可弯曲负压外鞘治疗2～3 cm肾结石的临床观察.临床泌尿外科杂志,2024,39(4):292-295.

备注/Memo

备注/Memo:
基金项目：首都卫生发展科研专项项目(2024-3-7036)**通讯作者，Email:13661387739@163.com①(北京中医药大学研究生院，北京100029)②(中国中医科学院西苑医院男科，北京100091)
更新日期/Last Update: 2026-05-21