输尿管封堵器在输尿管结石钬激光碎石术中的应用价值分析

Application value of ureter occluder in holmium laser lithotripsy of ureteral calculi

目的：研究输尿管管路封堵器在输尿管镜钬激光碎石术中的临床应用价值。方法：回顾性分析郑州大学第一附属医院2013年2月至2014年2月收治的78例输尿管结石患者,对输尿管结石合并积水患者在F3输尿管导管引导下置入英诺伟（TMIVX-SCl0）输尿管封堵器封堵结石后钬激光碎石。结果：成功封堵的75例（96.2%）输尿管镜（ureteroscopy,URS）手术,一次性彻底击碎结石。未有效封堵的3例手术中,2例辅助体外冲击波碎石术（extracorporeal shock wave lithotripsy,ESWL）,1例改经皮肾镜碎石术。手术时间为15-60 min,平均45.0 min;术后3-7 d出院,平均3.4 d;术中无输尿管穿孔、明显出血等严重并发症,结石清除率96.2%。结论：输尿管封堵器在输尿管镜下配合钬激光碎石能有效预防结石上移,明显提高清石率,安全性高,尤其对输尿管中上段结石疗效较好,值得临床推广。

Objective： To study the Application value of ureter occluder in holmium laser lithotripsy of ureteral calculi. Methods： 78 patients with ureteral calculi treated in the First Affiliated Hospital of Zhengzhou University from February 2013 to February 2014. Inno-wei（ TMIVX-SCl0） ureter occluder was used to block the ureter under the guidance of F3 ureteral catheter,and then holmium laser lithotripsy was done. Results： Calculi were one-time completely crushed in 75 patients（ 96. 2%） with successful closure. In three patients with uneffectively closure,two cases were assisted with ESWL surgery,one case was diverted to percutaneous nephrolithotomy. The operation time was 15 - 60 min,with an average of 45. 0 min; discharge time was 3 - 7 d after operation,with an average of 3. 4 d; there were no serious complications occurring in the operation,such as ureteral perforation,bleeding. The stone clearance rate was 96. 2%. Conclusion： The ureter occluder was effective in preventing the movement of calculus with the cooperation of holmium laser lithotripsy of ureteral calculi,with high stone clearance rate and safety,especially for upper ureteral calculi. It is worthy of clinical promotion.