论文部分内容阅读
目的:评估输尿管镜碎石术中联合使用管路封堵器治疗输尿管上段结石的有效性及安全性。方法:回顾性分析2012年6月~2013年3月收治的57例输尿管上段结石(结石最大径>10mm)患者的临床资料:患者均行输尿管镜碎石术。输尿管镜发现结石后,使用英诺伟IVX-SC10型管路封堵器完全超越结石,然后操作体外手柄使叶片折叠成球状防止结石上移,再行钬激光或气压弹道碎石,术后留置双J管2~4周。结果:54例使用管路封堵器一次碎石成功,成功率达94.7%;2例在放置管路封堵器超越结石时结石漂移至肾盏;1例因结石上方输尿管扩张明显,封堵器未能完全封堵,碎石过程中有较大结石碎片漂移至肾盏。术中未出现输尿管穿孔或输尿管黏膜撕脱,术后无患者体温>38.5℃,无严重肉眼血尿发生。术后1个月复查KUB,一次碎石成功的54例患者未见结石残留。结论:管路封堵器是输尿管镜碎石术中一种较为有效安全的辅助工具,能显著减少输尿管镜上段结石碎石术中结石漂移,提高输尿管上段结石的一次碎石成功率。
OBJECTIVE: To evaluate the effectiveness and safety of combined use of occluder device in the treatment of upper ureteral calculi in ureteroscopic lithotripsy. Methods: The clinical data of 57 patients with upper ureteral calculi (maximum diameter of stone> 10mm) admitted from June 2012 to March 2013 were retrospectively analyzed. All patients underwent ureteroscopic lithotripsy. Ureteroscopy found stones, the use of Inventive IVX-SC10-type pipe occluder completely beyond the stones, and then operate the body handle folds the leaves into a ball to prevent the stones on the move, then the holmium laser or pneumatic lithotripsy, postoperative indwelling Double J tube 2 to 4 weeks. Results: The success rate of 54 cases was 54.7% in 54 cases with pipeline occluder. The stones drifted to the calyx in 2 cases when the tube occluder was surpassing the calculus. The ureteral expansion in 1 case was obviously blocked and occluded Failed to completely block the device, during the gravel larger pieces of stone drift drift to the kidney calyx. No perforation of the ureter or ureteral mucosal avulsion occurred during operation. No postoperative temperature> 38.5 ℃ and no serious gross hematuria occurred. One month after the operation, KUB was reviewed. No stones were found in 54 patients with one gravel success. Conclusion: Pipe occluder is a more effective and safe auxiliary tool in ureteroscopic lithotripsy, which can significantly reduce the stone drift in lithotripsy of upper ureter and improve the success rate of primary stone in upper ureteral calculi.