6/7.5 F输尿管镜联合输尿管导管负压吸引治疗输尿管上段结石216例报告

6/7.5 F ureteroscope combined with ureteral catheter negative pressure suction for treatment of 216 cases with upper ureteral calculi

目的探讨应用6/7.5 F输尿管镜联合旁置输尿管导管负压吸引治疗输尿管上段结石的安全性及有效性。方法回顾性分析深圳市前海蛇口自贸区医院2019年1月至2020年12月采用6/7.5 F输尿管镜联合旁置输尿管导管负压吸引配合钬激光碎石治疗输尿管上段结石患者216例的临床资料。留置5 F输尿管导管越过结石上方,连接负压吸引,应用200μm钬激光击碎结石。结果216例患者中,术中共209例输尿管镜成功到达结石下方位置,上镜成功率96.8%;18例因整体或大部分结石移位至肾盂,一期行输尿管软镜碎石,结石上移率8.3%;术后低热5例,高热1例,感染率2.7%;拔管后20例KUB提示有>4 mm结石残留,清石率90.7%;所有病例均无输尿管穿孔、黏膜撕脱、感染性休克等严重并发症。结论6/7.5 F输尿管镜联合旁置输尿管导管负压吸引治疗输尿管上段结石安全、有效,可降低结石上移逃逸率,提高术后清石率,减少术后感染,临床效果确切。

Objective To explore the safety and effectiveness of 6/7.5 F ureteroscope combined with ureteral catheter negative pressure suction for treatment of upper ureteral calculi.Methods The data of 216 patients with upper ureteral calculi were treated with 6/7.5 F ureteroscope combined with ureteral catheter negative pressure suction and holmium laser lithotripsy in Qianhai Shekou Free Trade Zone Hospital from January 2019 to December 2020 were analyzed retrospectively.5 F ureteral catheter was placed through the stone and connected to negative pressure suction.200μm holmium laser was used to crush the stone.Results Among the 216 patients,209 cases were successfully reached the position below the stone during the operation,the success rate was 96.8%.18 cases were treated with flexible ureteroscopic lithotripsy because the whole or most of the stones returned to the renal pelvis,the stones migration rate was 8.3%.There were 5 cases of low fever and 1 case of high fever after operation,and the infection rate was 2.7%.After extubation,KUB showed residual stones larger than 4 mm in 20 cases,the stone clearing rate was 90.7%.No serious complications such as ureteral perforation,mucosal avulsion,and septic shock occurred.Conclusion 6/7.5 F ureteroscope combined with ureteral catheter negative pressure suction to treat upper ureteral calculi is safe and effective.It can reduce the rate of stone migration,increase the rate of postoperative stone clearance and reduce postoperative infection.