输尿管软镜在治疗体外冲击波碎石失败的飞行员肾脏小结石中的应用

Flexible ureteroscopy technology in the treatment of small kidney stones in pilots who failed in extracorporeal shock wave lithotripsy

目的:观察输尿管软镜技术在治疗体外碎石失败的飞行员肾脏小结石中的效果。方法:回顾分析2009年10月~2015年9月采用体外冲击波碎石(ESWL)治疗失败后进行输尿管软镜手术的26例单侧肾脏小结石飞行人员病例资料。结果:所有患者均为男性,年龄22~48岁。术前CT提示肾脏小结石,左肾11例,右肾15例,结石长径0.2~0.8cm,其中12例患者镜下发现结石,采用激光光纤将肾脏小结石击碎,部分结石碎片采用套石网篮取出,部分结石碎屑术后经尿路自行排出;14例患者镜下确诊肾乳头黏膜下钙化,未予特殊处理。术后随访6~24个月,肾乳头钙化斑较术前未见明显变化。结论:对于体外碎石治疗失败的飞行员上尿路结石,输尿管软镜手术是安全有效的治疗手段。

Objective:To observe the effect of flexible ureteroscopy technology treating small kidney stone in pilots who failed in extracorporeal shock wave lithotripsy.Methods:The clinical data of 26 pilots with unilateral small kidney stones were retrospectively analyzed from October 2009 to September 2015.All cases failed in extracorporeal shock wave lithotripsy,and flexible ureteroscopy surgery was given finally.Results:All patients were male,from 22 to 48years old,and all were diagnosed as unilateral small kidney stones by computed tomography(CT),with 11 lesions in the left kidney,and 15 in right.The major diameter of stone ranged from 0.2to 0.8cm.Among the 26 cases,12patients' kidney stones were found by flexible ureteroscopy,and were shattered by the Holmium laser.Besides,14 patients were diagnosed as renal papilla calcifications by flexible ureteroscopy,without any treatment.Patients were all qualified to fly,and flew safely after 6to 24months' follow-up.As for renal papilla calcifications,there was no significant difference before and after operation.Conclusions:For pilots with small kidney stones,if they fail in extracorporeal shock wave lithotripsy,flexible ureteroscopy could be a safe and effective therapeutic method.