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健侧奔跑位头端可弯曲负压鞘联合软镜在大负荷上尿路结石治疗中的应用

Application of healthy side running position and flexible bendable negative pressure suction ureteral access sheath combined with flexible ureteroscope for large upper urinary tract calculi
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摘要 目的:探讨健侧奔跑位头端可弯曲负压吸引鞘联合软镜治疗大负荷上尿路结石的有效性和安全性。方法:回顾性分析2023年1月至12月长江大学附属第一医院采用健侧奔跑位头端可弯曲负压吸引鞘联合软镜治疗>2 cm上尿路结石患者43例。分析其一般资料和围手术期观察指标。结果:43例患者中,男24例,女19例,结石长径(2.5±0.3)cm,CT值(1026±261.4)Hu。无肾积水14例,轻度肾积水21例,中度肾积水8例。37例患者一期完成手术,4例患者因结石负荷大、手术时间长行两次手术完成。平均手术时间(118±34)min,术后第1天结石清除率为79.1%(34/43),术后1月结石清除率为93.1%(40/43)。无集合系统、输尿管损伤,无严重出血等并发症。结论:头端可弯曲负压吸引鞘联合软镜治疗大负荷上尿路结石效果确切,安全可行。 Objective:To probe the effectiveness and safety of healthy side running position and flexible bendable negative pressure suction ureteral access sheath combined with flexible ureteroscope lithotripsy in the treatment of large upper urinary tract calculi.Methods:Clinical date of 43 patients with>2 cm upper urinary tract stones admitted to the First Affiliated Hospital of Yangtze University from January to December 2023 were retrospectively studied.The flexible ureteroscopic laser lithotripsy procedures were performed with healthy side running position and flexible bendable negative pressure suction ureteral access sheath.General information and perioperative data(stone clearance rate,operative time and complication)were summarized.Results:There were 24 males and 19 females in our case series.The mean calculi size was(2.5±0.3)cm and the mean calculi density measured by CT scan was(1026.0±261.4)Hu(Hounsfield units).There were 14 cases without hydronephrosis,21 cases with mild hydronephrosis,and 8 cases with mild hydronephrosis.37 cases were finished in single session,while 4 cases needed an additional session due to large stone and long operation time.The mean operation time was(118±34)min.The stone free rate 1 day and 1 month postoperatively was 79.1%(34/43)and 93.1%(40/43).There was no injury to the pelvis,ureter and severe bleeding complication.Conclusion:Healthy side running position and flexible bendable negative pressure suction ureteral access sheath combined with flexible ureteroscope lithotripsy in the treatment of large upper urinary tract calculi is safe and effective,having a definite threapeutic effect.
作者 张忠 代海涛 刘远华 马沛莉 彭昌伟 郭培超 胡振兴 Zhang Zhong;DaiHaitao;Liu Yuanhua;Ma Peili;Peng Changwei;Guo Peichao;Hu Zhenring(Department of Urology,the First Affiliated Hospital of Yangtze University,Jingzhou 434021,China)
出处 《微创泌尿外科杂志》 2024年第3期167-170,共4页 Journal of Minimally Invasive Urology
关键词 健侧奔跑位 输尿管软镜 可弯曲输尿管鞘 负压吸引 上尿路结石 healthy side running position flexible ureteroscope bendable ureteral access sheath negative pressure suction upperurinarytractcalculi
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