双输尿管导管在微创经皮肾镜钬激光碎石术中的应用

Application of double ureteral catheters in minimally invasive percutaneous nephrolithotomy with holmium laser lithotripsy

目的:探讨双输尿管导管在微创经皮肾镜钬激光碎石术中的应用。方法:对2009年6月～2012年5月采用双输尿管导管逆行插管法行超声引导下经皮肾镜取石术治疗的多发性肾结石28例临床资料进行回顾性分析。结果:28例均一次穿刺造瘘成功,碎石取石时间为25～120min,术中无结石颗粒进入输尿管腔,术中很容易确认UPJ位置,放置斑马导丝及顺行留置双J管均顺利。结论:双输尿管导管逆行插管法在经皮肾镜取石术中有助于阻挡结石颗粒下移入输尿管,有助于确定UPJ位置及放置斑马导丝及双J管,可节约手术时间;术后有助于小结石颗粒的排出,值得推广应用。

Objective：To explore the application of double ureteral catheters in minimally invasive pereutaneous nephrolithotomy. Methods： 28 patients with multiple renal calculi who accepted retrograde ureteral catherization with double ureteral catheters during mPCNL were retrospectively reviewed. Results： Percutaneous puncture was successful in all the 28 patients at a time, and it needed 25 to 120 minutes for lithotripsy and calculi extraction. No break calculi moved down into the ureter,It was very easy to find ureteropelvic junction（UPJ） and to insert zebra guide wire and double J tube. Conclusions：Double ureteral catheters can prevent break calculi from moving down in- to the ureter during mPCNL,may help surgeons find UPJ and insert zebra guide wire and double J tube. So opera- tion time may be saved. In addition, this technique may contribute to discharge small stone granules postoperative- ly. This technique is worthy of popularization and application in mPCNL.