输尿管硬镜联合导入鞘内芯扩张在导入鞘置入失败中的应用价值

Application Value of Ureteroscope in Combination With the Inner Core of Ureteral Access Sheath Dilatation for Placement Failure of Ureteral Access Sheath

目的探讨输尿管硬镜联合导入鞘内芯扩张输尿管下段在导入鞘置入失败时的应用价值。方法2017年1月~2018年12月,输尿管软镜钬激光碎石术中置入导入鞘失败57例,采用F 8/9.8输尿管硬镜联合导入鞘内芯扩张输尿管下段。结果经过扩张后顺利置入F 12导入鞘41例(71.9%),均未见输尿管穿孔或撕裂。扩张后仍未能置入导入鞘16例中,3例留置双J管4周后成功置入F 12导入鞘,11例行无导入鞘输尿管软镜钬激光碎石,2例行经皮肾镜碎石取石术。结论输尿管硬镜联合导入鞘内芯扩张输尿管下段安全、有效,值得推广。

Objective To investigate the application value of ureteroscope in combination with the inner core of ureteral access sheath(UAS)dilatation of lower ureteral for placement failure of UAS.Methods From January 2017 to December 2018,in 57 cases of placement failure of UAS during holmium laser lithotripsy under flexible ureteroscope,the F 8/9.8 ureteroscope in combination with the inner core of ureteral access sheath was used for dilation.Results The F 12 UAS of 41 patients were successfully implanted after dilation,and all patients had no ureteral perforation or laceration.Among the 16 cases who still had UAS placed difficultly after dilatation,3 patients after 4 weeks of indwelling double J tube were successfully inserted F12 UAS,11 patients underwent flexible ureteroscopy lithotripsy without UAS,and 2 patients underwent percutaneous nephrolithotomy.Conclusion Ureteroscope combined with inner core dilation of the lower segment of ureter is a safe and effective method,which is worthy of popularizing.