软镜下使用专利吸石测压输尿管扩张鞘结合钬激光治疗肾结石的临床研究

Clinical study on treatment of renal calculi with patent ureteral access sheath used in conjunction with vacuum suction system during flexible ureteroscopy

目的 总结114 例使用吸石测压输尿管扩张鞘配合钬激光治疗肾结石的临床经验.方法 2015 年3～9 月,使用专利吸石测压输尿管扩张鞘配合负压吸引装置联合输尿管软镜治疗114例肾结石患者.术中通过扩张鞘监测肾内压力,一边碎石一边吸石,于术后复查血液学检测指标,出院前复查腹部X 线平片观察清石效果.结果 术中初始肾内压力为5～24（9.1±2.55）mmHg,手术全程肾内压力为-10～46（5.52±3.77）mmHg,1 例患者术后出现发热,96 例（84.2%）患者术后复查腹部X 线平片及超声提示结石基本清除干净.结论 使用吸石测压输尿管扩张鞘配合输尿管软镜碎石,增加了手术安全性,减轻了患者术后排石负担,手术过程安全可行.

ObjectiveTo summarize the experience of using patent ureteral access sheath used in conjunction with vacuum suction system during flexible ureteroscopy to treat renal stones.MethodsUsing the flexible ureteroscopy, patent ureteral access sheath (UAS) and vacuum suction system to treat 114 renal stone cases from March to September in 2015. In the operation, the internal pressure of the kidney was monitored by patent UAS and cleared out the fragments by vacuum suction system. Blood test indexes were reviewed after surgery.Reviewed the effect of abdominal X ray plain film before hospital discharge. ResultsThe average initial pelvic pressure was (9.1±2.55) (5-24)mmHg. The average pelvic pressure was (5.52±3.77) (-10-46) mmHg. One patient had fever after the operation. KUB showedthat 84.2% patients’ calculus had removed completely.ConclusionsUsing the patent UAS in conjunction with flexible ureteroscopy for renal treatment is safety and effective technically, it could reduce the burden on patients with postoperative stone.