论文部分内容阅读
目的探讨超声引导经皮肾盏憩室穿刺辅助输尿管软镜(FURS)治疗肾盏憩室结石的临床价值,复习相关文献以提高对本病的认识。方法回顾性分析2014年8月至2015年7月共16例FURS寻找憩室开口困难患者,男7例,女9例,中位年龄48岁(27~83岁)。结石最大径中位数为12 mm(6-24mm)。斜仰卧截石位,超声辅助经皮穿刺憩室并注入美兰或插入导丝辅助FURS治疗憩室结石。结果16例均穿刺成功。10例经针鞘注入美兰后FURS可见蓝色液体自憩室口流出,6例未见蓝色液体流出。后6例经穿刺针鞘置入导丝辅助FURS辨认憩室位置并切开。16例均成功用钬激光切开憩室颈口或憩室壁,击碎并清除憩室内结石。无石率、碎石成功率和无症状率分别为75%(12/16)、87.5%(14/16)和100%(14/14)。术后2例发热经抗生素治疗后好转。中位住院时间为3d(2~5 d)。憩室术后3月6例消失,10例缩小。结论超声引导穿刺有助于FURS辨认肾盏憩室开口和位置,可能有助于提高的手术成功率。
Objective To investigate the clinical value of ultrasound-guided percutaneous calyceal diverticulum assisted ureteral soft-lens (FURS) in the treatment of calyceal diverticula calculus, and review the relevant literature to improve the understanding of this disease. Methods A retrospective analysis of 16 FURS patients with open diverticulum between August 2014 and July 2015 was performed. There were 7 males and 9 females with a median age of 48 years (range, 27-83 years). The median diameter of maximal calculus was 12 mm (6-24 mm). Slanted supine lithotomy position, ultrasound-assisted percutaneous puncture diverticulum and injection Meilan or insert guide wire assisted FURS treatment of diverticular stones. Results 16 cases were successful puncture. Ten cases were injected with melanocarcinoma FURS blue fluid visible from the diverticulum port outflow, 6 cases no blue liquid outflow. After 6 cases were punctured by the needle sheath into the wire assisted FURS identify diverticulum position and cut open. 16 cases were successful with holmium laser incision diverticulum neck or diverticulum wall, crushing and removal of diverticulum stones. The rates of stoneless, gravel success and asymptomatic were 75% (12/16), 87.5% (14/16) and 100% (14/14), respectively. After 2 cases of fever after treatment with antibiotics improved. The median length of stay was 3d (2 ~ 5 days). Diverticulum in March 6 cases disappeared, 10 cases narrowed. Conclusions Ultrasound-guided puncture helps the FURS identify the openings and locations of the calyceal diverticulum, which may help improve the success rate of surgery.