微创腔镜手术技术在治疗飞行人员难治性上尿路小结石中的应用

The application of minimally invasive endoscopic surgery to cure the flying personnel with intractable upper urinary tract stones

目的 观察微创腔镜手术技术治疗飞行人员难治性上尿路小结石的疗效. 方法 回顾分析2006年6月至2014年10月空军总医院采用微创腔镜手术技术诊疗的26例难治性上尿路结石飞行人员病例资料. 结果 患者均为男性,年龄24～50岁;输尿管结石13例,肾结石13例;术前CT提示结石长径0.2～0.8 cm.输尿管结石患者均因肾绞痛发作人院;肾结石患者均为体检行超声检查时发现,无腰腹疼痛、尿路刺激症状及肉眼血尿.13例输尿管结石患者采用输尿管硬镜碎石治疗,均治愈.肾结石患者中,10例单纯采用输尿管软镜治愈,1例患者单纯采用经皮肾镜治愈,2例患者采用输尿管软镜＋经皮肾镜联合治疗治愈.所有患者术后均医学鉴定为飞行合格. 结论 对于飞行人员难治性上尿路小结石,微创腔镜手术是安全有效的治疗手段,可避免因该疾病医学停飞,使飞行人员重返飞行岗位.

Objective To evaluate the therapeutic effect of minimally invasive endoscopic surgery in the treatment of intractable upper urinary tract stones for flying personnel.Methods We retrospectively analyzed the clinical records of pilots who accepted minimally invasive endoscopic surgery for intractable upper urinary tract stones at our hospital from June 2006 to October 2014.Results All patients are male,aging from 24 to 50 yr.There were 13 cases of ureteral calculus and 13cases of renal calculus.The CT scan showed that the long diameter of the stones ranged from 0.2 to 0.8 cm.All ureteral calculus patients were hospitalized because of renal colic.Renal calculus patients＇stones were found in routine health examination and there were no flank pain,urinary irritation symptoms and hematuria.Ureteral calculus patients were cured by ureteroscopic lithotripsy and recovered.Ten renal calculus patients were cured simply by flexible ureteroscopy.One renal calculus patient was cured simply by percutaneous nephrostolithotomy and 2 were cured by flexible ureteroscopy combine percutaneous nephrostolithotomy.All patients were qualified for flying after the surgeries.Conclusions The minimally invasive endoscopic surgery can cure the intractable upper urinary tract stones of flying personnel effectively and safely.The proper treatment would avoid flying personnel＇s grounding and enable them to continue their flight career.