输尿管镜内导管灌注在输尿管镜钬激光碎石术中的应用体会

Application of ureteral catheter irrigation during ureteroscopic holmium laser lithotripsy

目的：探讨输尿管镜内导管灌注在输尿管镜钬激光碎石术中的临床效果。方法：2010年7月-2012年7月应用输尿管镜内导管灌注行输尿管镜钬激光碎石术治疗60例输尿管结石患者。术中输尿管镜抵达结石下方后,将一根F4输尿管导管前端剪断约1cm（后改用F3Urorision前端开口输尿管导管）,输尿管导管自输尿管镜操作孔置入输尿管镜,导管开口位于输尿管镜头与结石之间,或者导管开口向上越过结石约2cm（视结石大小和有无嵌顿而定）,助手经输尿管导管末端推注0.9%氯化钠溶液,术者在输尿管导管内水流灌洗视野下碎石。结果：本组60例输尿管结石患者均使用此种方法,术中术野保持清晰,顺利完成手术,术中无输尿管穿孔、撕脱等并发症。结论：输尿管镜内导管灌注可使视野清晰,结石不易上移,预防反流性感染,疗效安全确切,并发症少。

Objective： To explore the clinical effects of ureteroscopic holmium laser lithotripsy combined with ureteral catheter irrigation for ureteral calculus. Method： A total of 60 cases of ureteral calculus were treated by ureteroscopic holmium laser lithotripsy. The ureteroscope was placed into the ureter. After finding the ureteral calculus, F4 ureteral catheter was placed to calculus via the ureteroscope. Then, we infused 0.9% NaCl solution via the bottom of ureteral catheter. Finally, lithotripsy was manipulated under the direct vision of ureteroscope and irrigation. Result： The operations of 60 patients were successfully completed, and the intraoperative surgical field remained clear. There were no ureteral perforation of the mucosa, avulsion or other complications. Conclusion： The ureteroscopic holmium laser lithotripsy combined with ureteral catheter continuous irrigation can ensure the clear surgical field, decrease the complication, and enhance the curative effects and safety.