[1]王映翔孙伟余浩然赵准临杨时来.输尿管软镜联合末端可弯曲负压吸引鞘治疗嵌顿性输尿管中下段结石[J].中国微创外科杂志,2026,01(7):417-422.
　Wang Yingxiang,Sun Wei,Yu Haoran,et al.Use of a Flexible Ureteroscope Combined With a Terminal Flexible Negative Pressure Suction Sheath for Treating Impacted Calculi in the Middle and Lower Ureters[J].Chinese Journal of Minimally Invasive Surgery,2026,01(7):417-422.
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输尿管软镜联合末端可弯曲负压吸引鞘治疗嵌顿性输尿管中下段结石()

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

卷:
01
期数:
2026年7期
页码:
417-422
栏目:
临床研究
出版日期:
2026-08-06

文章信息/Info

Title:
Use of a Flexible Ureteroscope Combined With a Terminal Flexible Negative Pressure Suction Sheath for Treating Impacted Calculi in the Middle and Lower Ureters
作者:
王映翔孙伟余浩然赵准临杨时来
(重庆大学附属涪陵医院泌尿外科，涪陵408000)
Author(s):
Wang Yingxiang;  Sun Wei;  Yu Haoran;  et al.
Department of Urology, Chongqing University Fuling Hospital, Fuling 408000, China
关键词:
嵌顿性结石; 输尿管中下段结石; 输尿管软镜手术
Keywords:
Impacted stone; Middle and lower ureteral stone; Flexible ureteroscopy
文献标志码:
A
摘要:
目的探讨输尿管软镜联合末端可弯曲负压吸引鞘治疗嵌顿性输尿管中下段结石的安全性和有效性。方法回顾性分析2023年1月~2025年12月采用输尿管软镜联合末端可弯曲负压吸引鞘治疗嵌顿性输尿管中下段结石31例资料。结石位于输尿管中段28例，下段3例，CT值(849.2±240.2)HU，长径(8.1±1.2)mm，横径(5.9±1.4)mm，肾积水直径(23.4±8.5)mm，合并输尿管息肉24例。术前尿白细胞(-)14例，(+)~(3+)17例。结果30例一期完成软镜手术并获结石完全清除（CT未见结石残留）；1例置鞘失败，留置支架管2周后手术并获结石完全清除。手术时间(67.4±24.3)min，术后住院时间(2.8±1.3)d。结石成分分析提示含草酸钙类24例，尿酸结石4例，碳酸磷灰石3例。ClavienDindo Ⅰ级术后并发症发生率12.9%(4/31)，无ClavienDindo Ⅱ级以上术后并发症、输尿管镜术后损伤分级(Postureteroscopic Lesion Scale，PULS)2级以上输尿管损伤、严重血尿、脓毒血症以及包膜下血肿。31例术后随访2~7个月，平均4.0月，未见结石复发、输尿管狭窄。结论输尿管软镜联合末端可弯曲负压吸引鞘治疗嵌顿性输尿管中下段结石安全、有效。
Abstract:
ObjectiveTo evaluate the safety and effectiveness of a flexible ureteroscope combined with a terminal flexible negative pressure suction sheath for the treatment of impacted stones located in the middle and lower ureters.MethodsWe conducted a retrospective analysis of clinical data from 31 patients with impacted stones in the middle and lower ureters who underwent treatment using a flexible ureteroscope combined with a terminal flexible negative pressure suction sheath between January 2023 and December 2025. Stones were predominantly located in the middle section of the ureter in 28 cases, with 3 cases found in the lower section. The computed tomography (CT) value of the stones was (849.2±240.2) HU. The average stone length was (8.1±1.2) mm, while the transverse diameter measured (5.9±1.4) mm. Hydronephrosis was present with a diameter of (23.4±8.5) mm, and 24 cases exhibited ureteritis polyps. Preoperative urinary leukocyte counts were (-) in 14 cases and (+)-(3+) in 17 cases.ResultsThirty patients underwent onestage flexible ureteroscopy with complete stone clearance (no residual calculi detected on CT). Ureteral access sheath insertion failed in 1 case, which required stenting for 2 weeks followed by successful secondstage flexible ureteroscopy and complete stone clearance. The average operation time was (67.4±24.3) min, and the average postoperative hospitalization duration was (2.8±1.3) d. Analysis of the postoperative stone components revealed that 24 cases contained calcium oxalate, 4 cases were identified as uric acid stones, and 3 cases were classified as carbonated apatite. The ClavienDindo grade Ⅰ complications occurred in 12.9% (4/31). No complications of ClavienDindo grade Ⅱ or higher, ureteral injuries of Postureteroscopic Lesion Scale (PULS) grade 2 or higher, severe hematuria, sepsis, or subcapsular hematoma occurred postoperatively. During postoperative followups for 2-7 months (mean, 4.0 months) in the 31 patients, no stone recurrence or ureteral stricture was noted.ConclusionFlexible ureteroscope combined with a terminal flexible negative pressure suction sheath is safe and effective for the treatment of impacted middle and lower ureteral calculi.

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备注/Memo

备注/Memo:
通讯作者，Email：yyyshilai@126.com
更新日期/Last Update: 2026-08-06