[1]秦海生 张文涛* 陈俊明 杨胜进.针状可视肾镜治疗肾盏憩室结石（附36例报告）[J].中国微创外科杂志,2021,01(10):870-874.
　Qin Haisheng,Zhang Wentao,Chen Junming,et al.Treatment of Caliceal Diverticular Calculi With Needlelike Visual Nephroscope: a Report of 36 Cases[J].Chinese Journal of Minimally Invasive Surgery,2021,01(10):870-874.
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针状可视肾镜治疗肾盏憩室结石（附36例报告）()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年10期
页码:
870-874
栏目:
临床研究
出版日期:
2021-10-25

文章信息/Info

Title:
Treatment of Caliceal Diverticular Calculi With Needlelike Visual Nephroscope: a Report of 36 Cases
作者:
秦海生 张文涛* 陈俊明 杨胜进
（武警河南省总队医院泌尿外科，郑州450000）
Author(s):
Qin Haisheng;  Zhang Wentao;  Chen Junming;  et al.
Department of Urology, Armed Police Corps Hospital of Henan, Zhengzhou 450000, China
关键词:
针状可视肾镜; 钬激光; 肾盏憩室结石
Keywords:
Needlelike visual nephroscope; Holmium laser; Caliceal diverticular calculi
文献标志码:
A
摘要:
目的探讨超声引导下针状可视肾镜联合钬激光处理直径 1.0～2.5 cm 肾盏憩室结石的临床疗效。 方法全身麻醉成功后输尿管镜下在患侧放置 F5 输尿管导管，并留置 F18 三腔尿管固定。改行俯卧位，在超声引导、显示器直视下，针状可视肾镜进入目标盏，留置硬导丝，应用扩张套件从 F8 逐号扩张至 F14 ，连接 F8 可视肾镜碎石清石系统，550 μm钬激光光纤将结石粉碎并吸出。若憩室盏颈口难以寻及，沿输尿管导管逆行推注10％亚甲蓝，找到盏颈口后用钬激光将盏颈口切开，顺行置入 F6 输尿管支架管。结果36 例均一次碎石取石成功。手术时间 33～65 min,平均 47.5 min。术后血红蛋白下降 0.6～1.9 g/L，平均 1.35 g/L。1 例术中第1天出现发热，体温38.5 ℃,积极抗感染后体温恢复正常。6 例术后出现肉眼血尿，尿管引流液呈暗红色，给予对症止血、卧床及膀胱冲洗后血尿逐渐停止，均无需输血。术后住院 4～6 d,平均 5.2 d。术后6、12个月复查肾脏CT，36例肾脏结石无复发，清石率 100.0%（36/36）。结论针状可视肾镜治疗肾盏憩室结石安全、有效。
Abstract:
ObjectiveTo investigate the clinical effect of ultrasoundguided needlelike visual nephroscope combined with holmium laser in the treatment of 1.0-2.5 cm diameter caliceal diverticular calculi.MethodsAfter successful anesthesia, the ureteroscope was used to place the F5 ureteral catheter on the affected side, and the F18 three chamber catheter was retained for fixation. Then the patients were changed to the prone position. Under the guidance of ultrasound and the direct view of the display, the needlelike visual nephroscope was entered the target calices, and the hard guide wire was retained. The calyx was expanded from F8 to F14 one by one with the expansion kit. Then the F8 visual nephroscope lithotripsy and stone clearing system was connected. The 550 μm holmium laser fiber was used to crush and suck out the stones. If it was difficult to find the calyceal neck of diverticulum, 10% methylene blue was retrogradely injected along the ureteral catheter. After the calyceal neck was found, the calyceal neck was cut open with holmium laser, and the F6 ureteral stent was placed along the way.ResultsAll 36 cases were treated successfully at one session. The operation time was 33-65 min (mean, 47.5 min). Postoperative hemoglobin decreased by 06-1.9 g/L (mean, 1.35 g/L). One patient had fever on the first day after operation, with a temperature of 38.5 ℃, and the temperature returned to normal after active antiinfection therapy. In 6 cases, hematuria occurred with naked eyes and the drainage fluid of urinary tube was dark red. Hematuria stopped gradually after hemostasis, bed rest and bladder washing. No blood transfusion was needed. The postoperative hospitalization time was 4-6 d (mean, 5.2 d). The renal CT was reexamined 6 and 12 months after operation. There were no caliceal diverticular calculi in the 36 cases. The stone removal rate was 100.0%(36/36).ConclusionIt is safe and effective to treat caliceal diverticular calculi with needlelike visual nephroscope.

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备注/Memo

备注/Memo:
*通讯作者，Email：zhangwt2059@126.com
更新日期/Last Update: 2022-02-08