[1]胡力仁 范先明** 林剑锋 涂建平 梁福律 叶志彬 张明芽 李亚楠 郭昭建.可弯曲负压吸引鞘联合输尿管软镜治疗2~3 cm上尿路结石[J].中国微创外科杂志,2022,01(9):763-766.
　Hu Liren,Fan Xianming,Lin Jianfeng,et al.Application of Flexible Negative Pressure Ureteral Access Sheath Combined With Flexible Ureteroscope in the Treatment of 2-3 cm Upper Urinary Tract Stones[J].Chinese Journal of Minimally Invasive Surgery,2022,01(9):763-766.
点击复制

可弯曲负压吸引鞘联合输尿管软镜治疗2~3 cm上尿路结石()
分享到：

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

卷:
01
期数:
2022年9期
页码:
763-766
栏目:
经验交流
出版日期:
2023-01-13

文章信息/Info

Title:
Application of Flexible Negative Pressure Ureteral Access Sheath Combined With Flexible Ureteroscope in the Treatment of 2-3 cm Upper Urinary Tract Stones
作者:
胡力仁 范先明** 林剑锋 涂建平 梁福律 叶志彬 张明芽 李亚楠 郭昭建
(福建中医药大学附属厦门市第三医院泌尿外科，厦门361100)
Author(s):
Hu Liren;  Fan Xianming;  Lin Jianfeng;  et al.
Department of Urology, Third Hospital of Xiamen Affiliated to Fujian Traditional Chinese Medical University, Xiamen 361100, China
关键词:
上尿路结石;  可弯曲负压吸引鞘;  输尿管软镜
Keywords:
Upper urinary tract calculi; Flexible negative pressure ureteral access sheath; Flexible ureteroscope
文献标志码:
B
摘要:
目的探讨可弯曲负压吸引鞘联合输尿管软镜治疗上尿路较大结石(2~3 cm)的效果。方法回顾性分析2021年9~11月应用可弯曲负压吸引鞘联合F7.5一次性输尿管软镜治疗上尿路较大结石16例资料。肾结石14例，结石大小2.4~3.2 cm，(2.50±3.66)cm；输尿管上段结石2例，大小分别为2.0 cm、2.4 cm。结果手术均顺利完成，未出现大出血、发热、感染性休克、输尿管石街形成等严重并发症。术后第3天复查CT，14例无结石残留，2例肾下盏结石残留0.6 cm，体外冲击波碎石排出。结论可弯曲负压吸引鞘联合输尿管软镜治疗2~3 cm上尿路结石可行且有效。
Abstract:
ObjectiveTo report the feasibility, safety, and effectiveness of flexible negative pressure ureteral access sheath combined with flexible ureteroscope lithotripsy in the treatment of 2-3 cm upper urinary tract calculi.MethodsA retrospective analysis of 16 patients with 2-3 cm upper urinary tract calculi, which were treated by using a F7.5 negative pressure ureteral access sheath combined with flexible ureteroscope lithotripsy in our hospital from September to November 2021, was reviewed. There were 14 cases of kidney stones, with a size of 2.4-3.2 cm (mean,2.50±3.66 cm), and 2 cases of upper ureteral stones with sizes of 2.0 cm and 2.4 cm, respectively.ResultsThe operation was completed in all the patients. There were no serious complications, such as hemorrhage, fever, septic shock, or ureteral stone formation during and after the operation. CT reexamination on the third day after operation showed that 14 cases had no residual stones. Two cases had residual stones of 0.6 cm in the lower renal calyx, and extracorporeal shock wave lithotripsy was used for removal. ConclusionFlexible negative pressure ureteral access sheath combined with flexible ureteroscope lithotripsy for 2-3 cm upper urinary tract calculi is a feasible and effective method.

参考文献/References:

[1]Seitz C,Desai M,Hcker A,et al.Incidence,prevention,and management of complications following percutaneous nephrolitholapaxy.Eur Urol,2012,61(1):146-158.
[2]吕建志,王鑫哲,赵战魁,等.输尿管软镜联合负压吸引治疗感染性肾结石的Meta分析.中国内镜杂志,2021,27(8):52-60.
[3]Jiang P,Xie L,Arada R,et al.Qualitative review of clinical guidelines for medical and surgical management of urolithiasis:consensus and controversy 2020.J Urol,2021,205(4):999-1008.
[4]黄健,王建业,孔垂泽,等.中国泌尿外科和男科疾病诊断治疗指南.北京:科学出版社,2019.237-259.
[5]Zhu M,Wang X,Shi Z,et al.Comparison between retrograde intrarenal surgery and percutaneous nephrolithotripsy in the management of renal stones:a metaanalysis.Exp Ther Med,2019,18(2):1366-1374.
[6]Karakoyunlu AN,Cakici MC,Sari S,et al.Comparison of retrograde intrarenal surgery and percutaneous nephrolithotomy methods for management of bigsized kidney stones (≥4 cm):single center retrospective study.Urol J,2019,16(3):232-235.
[7]高小峰,李凌,彭泳涵,等.输尿管软镜联合钬激光治疗2~4cm肾结石疗效分析.微创泌尿外科杂志,2013,2(1):47-49.
[8]Jung H,Nrby B,FrimodtMller PC,et al.Endoluminal isoproterenol irrigation decreases renal pelvic pressure during flexible ureterorenoscopy:a clinical randomized,controlled study.Eur Urol,2008,54(6):1404-1413.
[9]赵振华,赵国平,郑东升,等.输尿管软镜碎石术后尿脓毒血症的危险因素分析.中华腔镜泌尿外科杂志(电子版),2018,12(1):16-19.
[10]钟文,曾国华,杨后猛,等.微创经皮肾镜取石术中肾盂内压变化对术后发热的影响.中华泌尿外科杂志,2008,29(10):668-671.
[11]Kuo RL,Aslan P,Zhong P,et al.Impact of holmium laser settings and fiber diameter on stone fragmentation and endoscope deflection.J Endourol,1998,12(6):523-527.
[12]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.
[13]Fang L,Xie G,Zheng Z,et al.The effect of ratio of endoscopesheath diameter on intrapelvic pressure during flexible ureteroscopic lasertripsy.J Endourol,2019,33(2):132-139.
[14]Matlaga BR,Chew B,Eisner B,et al.Ureteroscopic laser lithotripsy: a review of dusting vs fragmentation with extraction.J Endourol,2018,32(1):1-6.

备注/Memo

备注/Memo:
基金项目：福建省卫生创新课题(2017-CXB-18)**通讯作者，Email：fanxianming666@yeah.net
更新日期/Last Update: 2023-01-13