组合式输尿管软镜一期治疗双侧<1.5cm肾结石的安全性及有效性分析

Safety and effectiveness of modular flexible ureteroscope combined with holmium laser lithotripsy in treatment of bilateral renal calculi smaller than 1.5 cm

目的评价组合式输尿管软镜钬激光碎石术一期治疗双侧<1.5 cm肾结石的安全性及有效性。方法回顾性分析2014年8月-2016年3月采用组合式输尿管软镜一期治疗的双侧<1.5 cm肾结石24例患者的临床资料,分析手术时间、结石清除率及并发症发生情况。结果该组24例患者均一期顺利置入双侧输尿管软镜鞘,并顺利进镜碎石,手术时间40~105(71.0±21.5)min,碎石成功率为100.00%,1个月结石清除率为89.58%(43/48),5侧结石残留直径7~10 mm,给予体外冲击波碎石,3个月结石清除率93.75%(45/48),3侧残余结石5~7 mm,且位于下盏,定期复查。术后发热4例,抗炎治疗好转,术中无大出血、输尿管穿孔和撕脱等并发症,术后无肾功能不全、无感染性休克发生。结论组合式输尿管软镜碎石术可一期治疗双侧<1.5 cm肾结石,具有安全、有效的优势。

Objective To evaluate the safety and effectiveness of modular fexible ureteroscope combined with holmium laser lithotripsy in treatment of bilateral renal calculi smaller than 1.5 cm. Methods Clinical data of 24 patients from August 2013 to March 2016 using a modular fexible ureteroscope in treatment of bilateral renal calculi smaller than 1.5 cm was retrospectively analyzed. The clinical data included operation time, stone clearance rate and occurrence of complications. Results All the 24 patients were successfully placed in bilateral ureteral sheath soft lenses, and enter lithotripsy smoothly. The operation time was 40~105 （71.0 ± 21.5） min. Lithotripsy success rate was 100.00% and 1 month stone clearance rate was 89.50% （43/48）, 5 sides with residual stones diameter 7~10 mm, were given extracorporeal shock wave lithotripsy, 3 months stone clearance rate was 93.75% （45/48）, 3 sides with residual stones 5~7 mm located lower calyx accepted regular review. 4 cases with postoperative fever were cured after anti-infammatory treatment. There was no bleeding, ureteral perforation, postoperative avulsion, renal dysfunction, septic shock and other complications. Conclusion Modular fexible ureteroscope lithotripsy in treatment of bilateral renal calculi smaller than 1.5 cm is safe and effective.