结石封堵器在经皮微通道输尿管镜钬激光碎石中的应用

Application of stone occlusion device in percutaneous ureteroscopy microchannel holmium laser lithotripsy

目的总结结石封堵器在经皮微通道输尿管镜钬激光碎石术中阻止碎石下移的应用效果。方法复杂性肾结石患者22例,其中,铸型或鹿角形结石16例,肾多发性结石6例。结石直径1.5-4.0cm。超声引导下经膀胱镜将结石封堵器置于输尿管上段肾盂输尿管连接处,在超声引导下行经皮输尿管镜微通道大功率钬激光碎石治疗复杂性肾结石。结果 22例均成功放置封堵器,结石清除率90%。无发生碎石漂移病例;1例术后发生大出血。结论应用结石封堵器,可有效阻止微通道输尿管镜大功率钬激光碎石期碎石下移,提高结石清除率。

Objective To summarize the application of stone occlusion device（SOD）for stopping the gravel drift in the patients underwent percutaneous ureteroscopy microchannel holmium laser lithotripsy.Methods Holmium laser lithotripsy was performed in 22 patients with renal cast or antler shape stones（16 cases）and multiple kidney stones（6 cases）.The stones were 1.5-4.0cm in diameter.Before holmium laser lithotripsy,a SOD was inserted into the ureteropelvic junction by ultrasound-guided cystoscopy.Results The SOD was inserted and holmium laser lithotripsy was performed successfully in all 22 cases with a stone clearance rate of 90%.There was no any gravel drift during lithotripsy.Renal hemorrhage occurred after percutaneous nephrolithotomy in one case.Conclusion SOD can effectively stop the gravel drift and improve the stone clearance rate in the patients underwent percutaneous ureteroscopy microchannel holmium laser lithotripsy.