输尿管球囊扩张导管在治疗无积水肾结石中的应用

Application of ureteral balloon dilation catheter in treatment of renal calculi without hydronephrosis

目的探讨应用输尿管球囊扩张导管在治疗无积水肾结石中的疗效与安全性。方法对38例无积水肾结石患者,应用输尿管球囊扩张导管建立人工肾积水,超声定位穿刺,建立扩张经皮肾手术通道,钬激光碎石。结果 38例患者均成功建立了人工肾积水,均一次穿刺成功并建立经皮肾手术通道碎石,一期顺利完成手术。34例术后无残余结石,4例残余结石直径小于3 mm。平均手术时间(75.2±18.2)min,平均出血量(20.2±10.3)ml,无气胸、腹腔脏器损伤等并发症发生,无输血或改开放手术病例,所有病例均随访(8±2)个月,未出现继发性输尿管狭窄病例。结论输尿管球囊扩张导管是一种治疗无积水肾结石简单、安全、有效的方法,值得推荐。

Objective To explore the efficacy and safety with ureteral balloon dilation catheter for establishing artificial hydronephrosis in the treatment of renal calculi without hydronephrosis. Methods Ureteral balloon dilation catheter were applied for establishing artificial hydronephrosis in the treatment of 38 cases of renal calculi without hydronephrosis. All the patients underwent puncture by ultrasound guidance to establish percutaneous renal operation channel and holmium laser lithotripsy. All the patients were followed up for （8 ±2） months, and no ureteral stricture was found. Results All patients were successfully established artificial hydronephrosis and punctured to form percutaneous renal operation channel for lithotripsy by one-time. The first stage of lithotripsy was performed successfully in all cases, of which 34 cases without residual stones and 4 cases without residual stones in diameter less than 3 mm in postoperative examination. The average operation time and blood loss was 75 minutes and 20 ml, respectively. No severe complication occurred, such as pneumothorax and injury of abdominal organ. No transfusion and conversion to open surgery is obversed. Conclusions Using ureteral balloon dilation catheter for establishing artificial hydronephrosis in the treatment of renal calculi without hydronephrosis is simple, safe, effective and worth recommending.