输尿管导管辅助软镜工作内鞘扩张输尿管在二期软镜碎石术中置鞘困难时的应用

Clinical application of ureteral catheter and the inner core of ureteral access sheath dilate ureter in secondary flexible ureteroscope lithotripsy with placement difficult of ureteral access sheath

目的探讨输尿管导管辅助软镜工作内鞘扩张输尿管在二期输尿管软镜碎石术中置鞘困难时的临床应用。方法对一期放置5F输尿管支架管、二期行输尿管软镜碎石术时置鞘困难的9例患者,采用5F输尿管导管辅助12F软镜工作内鞘扩张输尿管后置鞘并行输尿管软镜钬激光碎石术。结果经扩张后的9例患者,软镜工作鞘均置于满意位置并成功碎石,未出现严重并发症。术后随访6个月未发现输尿管狭窄。结论应用输尿管导管辅助软镜工作内鞘扩张输尿管对二期行输尿管软镜碎石术置鞘困难的患者有提高手术成功率、降低手术风险、减轻经济负担的作用,是二期行输尿管软镜碎石术出现置鞘困难时有效、便捷、安全的辅助手段。

Objective To evaluate the clinical application of ureteral catheter and the inner core of ureteral access sheath dilate ureter in secondary flexible ureteroscope lithotripsy with placement difficult of ureteral access sheath.Methods For nine patients were treated with 5F ureteral stent placement in one stage and flexible ureteroscope lithotripsy with placement difficult of ureteral access sheath in the second stage,5F ureteral catheter and the 12F inner core of ureteral access sheath were used to dilate the ureter,then ureteral access sheath was placed and flexible ureteroscope holmium laser lithotripsy followed.Results The ureteral access sheath of nine patients were placed in a satisfactory position after dilation,and lithotrity was successfully performed,all patients were no serious complications.No ureteral stricture occurred in 6 months of postoperative follow-up.Conclusion The clinical application of ureteral catheter and inner core of ureteral access sheath dilatation of ureter can improve the successful rate of operation,reduce operation risks and the financial burden of patients.It is safe,effective and convenient method.