术前留置输尿管内支架管在导引鞘下输尿管软镜治疗婴幼儿肾结石的应用研究

Clinical application research of preoperative ureteral stent placement in the treatment of infantile kidney stone disease through flexible ureteroscopy applying ureteral guiding sheath

目的探讨术前留置输尿管支架管在输尿管导引鞘下输尿管软镜治疗婴幼儿肾结石的临床疗效。方法我院2015年6月至2018年6月收治24例肾结石婴幼儿(观察组),行输尿管软镜下激光碎石,术前留置输尿管支架,被动扩张输尿管2周后再置入输尿管软镜导引鞘完成输尿管软镜下激光碎石术,并对比分析同期17例未置入输尿管软镜导引鞘行输尿管软镜下激光碎石术(对照组)的患者资料。结果观察组结石清除率为87.5%,手术时间(56±14) min,术后发热1例,较对照组结石清除率76.5%明显提高,术后泌尿系感染发生率降低。结论术前行输尿管支架被动扩张后置入输尿管软镜导引鞘提高输尿管软镜下碎石治疗婴幼儿肾结石手术的成功率及安全性。

Objective To evaluate the clinical effect of preoperative ureteral stent placement in the treatment of infantile kidney stone disease through flexible ureteroscopy applying ureteral guiding sheath. Methods From June 2015 to June 2018, 24 infants(observation group) with renal calculi underwent laser lithotripsy through flexible ureteroscope in our hospital. Ureteral stent was placed before operation. After passive dilatation of ureter for 2 weeks, laser lithotripsy was performed by flexible ureteroscopy with ureteral guiding sheath. Another 17 infants(Control group) received laser lithotripsy by flexible ureteroscopy without ureteral guiding sheath and compared the clinical data of the two groups. Results In observation group, the clarence rate of stone was 87.5% and the operative time was(56±14) min. Moreover, one case had fever after operation. Compared with control group, the stone clearance rate 76.5% was significantly improved, as well as the incidence of urinary tract infection was reduced postoperatively. Conclusion preoperative ureteral stent placement could improve the success rate and safety of infant nephrolithiasis treatment by applying flexible ureteroscopy with ureteral guiding sheath.