摘要
目的应用可弯曲负压输尿管鞘,联合输尿管软镜钬激光碎石治疗上尿路结石,观察手术碎石效率、清石率及安全性。方法选取2021年4月至2022年1月上尿路结石手术患者86例,其中男55例,女31例,输尿管上段结石27例,肾结石59例,多发性结石39例,单发结石47例。使用本院专利产品一次性可弯曲负压吸引输尿管鞘进行手术,观察指标并随访。结果85例顺利完成输尿管软镜钬激光碎石手术,1例因输尿管狭窄,予再次置管2周后,完成手术治疗。手术时间8~183 min,平均65.2 min。术后发热2例(2.3%)。术后1月结石清除率为95.3%。实行术后无管化11例。所有患者均无明显腰酸腰痛、无肾周血肿、石街等并发症。结论可弯曲负压输尿管鞘可随输尿管软镜弯曲而进入肾盂及肾盏,且有负压吸引功能,可使肾盂内压更加稳定,手术视野更清晰,减少手术并发症,提高无石率(SFR),保证手术安全高效,值得在上尿路结石手术治疗中推广应用。
Objective To evluate the efficacy and safety of tip-flexible vacuum-assisted ureteral access sheath in flexible ureteroscopic laser lithotripsy.Methods Clinical data of 86 patients underwent flexible ureteroscopic laser lithotripsy between April 2021 and January 2022 were reviewed retrospectively.All the patients were pre-stented 2 weeks prior to lithotripsy procedure.The flexible ureteroscopic laser lithotripsy procedures were performed with a novel tip-flexible vacuum-assisted ureteral access sheath.There were 55 males and 31 females in our case series,with age ranged 19-85 years old.The mean calculi size was 16.6 mm(range 9.0 to 42.0 mm).Twenty-seven calculus located in the upper ureter and 59 calculus located in the kidney.Thirty-nine cases were multiple calculus,while 47 were single.Results Eighty-five cases were finished uneventfully,while 1 procedure failed because of ureter stricture and completed after another 2 weeks'stenting.The mean operative time was 65.2min(range 8 to 183mins).Two cases experienced post-operative fever(2.3%).The stone-free rate was 95.3%1 month post operation.Eleven cases were not stented post laser lithotripsy procedure.No patients suffered from renal colic,hematoma and steinstrasse post-operatively.Conclusion Tip-flexible vacuum-assisted ureteral can lower renal pelvis pressure(RPP),maintain clear intra-operative vision,reduce complication rate and increase stone free rate.It is safe and effective while implicated in flexible ureteroscopic laser lithotripsy.vision,reduce complication rate and increase stone free rate.It is safe and effective while implicated in flexible ureteroscopic laser lithotripsy.
出处
《浙江临床医学》
2024年第5期710-712,共3页
Zhejiang Clinical Medical Journal
基金
浙江省医药卫生科技计划项目(2021KY1171)
浙江省医药卫生科技计划县域专项(2024XY063)。
关键词
钬激光
可弯曲
负压
输尿管鞘
泌尿系结石
Holmium laser
Flexible
Negative pressure
Ureter sheath
Urinary stones
