输尿管软镜技术治疗马蹄肾结石的可行性分析

The feasibility analysis of flexible ureteroscope in management of renal calculi in horseshoe kidney

目的 探讨并研究输尿管软镜钬激光碎石术治疗马蹄肾合并肾结石的可行性分析及预后评价.方法 2014年6月～ 2014年12月对2例马蹄肾合并肾结石患者行输尿管软镜钬激光碎石术,术前留置F6双J管1～2周,并行泌尿系CT平扫及腹平片检查,提前应用抗生素.术中放置输尿管镜扩张鞘,后置入poly分体式输尿管软镜抵达肾盂清石.术后复查腹平片及泌尿系CT.结果 2例手术均获得成功,其中1例1个月后行二期碎石.手术时间分别为70min、85min（二期碎石）、65 min,其中有效碎石时间每次均不超过40min.术后2d即恢复出院.2例患者均未出现继发出血、感染等并发症.结论 输尿管软镜技术治疗马蹄肾结石疗效确切,并发症少,可行性高,值得临床中推广.

Objectives To investigate the therapeutic effect of horseshoe kidney with stones by flexible ureteroscopy（F-URS） and feasibility analysis.Methods From June 2014 to October 2014, two cases of renal calculi in horseshoe kidney were treated by POLY flexible ureteroscope Before operations, we placed F6 double-J stents for more than one week, used antibiotics before the operations.The patients were also underwent with computed tomography and plain radiography of the kidneys, ureters and bladder.The ureteral access sheaths were first placed during operations, then ureteroscope were inserted into the renal pelvis.Results Two patients were operated successfully, with one of them were treated for twice after one month.The operating time was 70 min, 85 min （second operation）, and 65 min.The time for use holmium laser was no more than 40 min, and hospital.resting for 2 days.Both patients were not underwent secondary hemorrhage, infection and other complications.Conclusions Flexible ureteroscopy is a effective, safe, highly probable treatment for renal calculi in horseshoe kidney.