輸尿管軟鏡鈥激光碎石治療腎輸尿管上段結石150例_West China Medical Journal

Authors：

 張力 , 胡興平 , 張川 , 王凱 , 李涵

成都市第五人民醫院泌尿外科 (成都 611130);

Corresponding?author：

Keywords：

腎輸尿管上段結石; 輸尿管軟鏡; 鈥激光

DOI：

10.7507/1002-0179.201600199

Video：

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目的評價輸尿管軟鏡鈥激光碎石治療腎輸尿管上段結石的效果，探討操作技巧。方法 2010年9月－2014年9月行輸尿管軟鏡鈥激光碎石治療的腎輸尿管上段結石患者150例，結石直徑為0.8～4.2 cm。早期患者均先置F5雙J管2周，再行輸尿管軟鏡碎石。自2014年起均采用直接一期輸尿管軟鏡碎石，術后3～5 d及術后4周復查腹部X線片及CT，評價碎石及排石效果。結果輸尿管軟鏡一次性進鏡率98.7%（148/150）；碎石成功率98.7%（148/150）；結石清除率97.3%（146/150）；手術時間20～126 min，平均40 min。2例術后出現尿源性敗血癥，經治療緩解。結論輸尿管軟鏡鈥激光碎石手術創傷小，恢復快，并發癥發生率低，結石排凈率高，是治療腎輸尿管上段結石安全有效的方法。

Citation： 張力, 胡興平, 張川, 王凱, 李涵. 輸尿管軟鏡鈥激光碎石治療腎輸尿管上段結石150例. West China Medical Journal, 2016, 31(4): 734-735. doi: 10.7507/1002-0179.201600199 Copy

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5.	劉東亮, 朱蜀俠, 袁丹, 等. 輸尿管軟鏡聯合輸尿管硬鏡鈥激光碎石術治療復雜性輸尿管上段結石[J]. 四川醫學, 2015, 36(5): 632-635.
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7.	葉利洪, 李雨林, 李王堅, 等. 腎下盞解剖結構對輸尿管軟鏡下鈥激光碎石治療腎下盞結石療效的影響[J]. 中華泌尿外科雜志, 2013, 34(1): 24-27.
8.	楊嗣星, 宋超, 劉凌琪, 等. 輸尿管鏡下鈥激光碎石與經皮腎鏡取石術治療腎結石的療效比較[J]. 中華泌尿外科雜志, 2013, 34(9): 666-669.
9.	Buscarini M, Conlin M. Update on flexible ureteroscopy[J]. Urol Int, 2008, 80(1): 1-7.
10.	Herrera-Gonzalez G, Netsch C, Oberhagemann K, et al. Effectiveness of single flexible ureteroscopy for multiple renal calculi[J]. J Endourol, 2011, 25(3): 431-435.
11.	劉齊貴, 張文滔, 段娟, 等. 輸尿管軟鏡結合鈥激光治療腎結石的療效觀察[J]. 中國微創外科雜志, 2012, 12(3): 239-241.
12.	Pasqui F, Dubosq F, Tchala K, et al. Impact on activescope deflection and irrigation flow of all endoscopic working tools during flexible uroterocopy[J]. Eur Urol, 2004, 45(1): 58-64.
13.	Takazawa R, Kitayama S, Tsujii T. Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater[J]. Int J Urol, 2012, 19(3): 264-267.
14.	Ben Saddik MA, Al-Qahtani Sejiny S, Ndoye M, et al. Flexible ureteroscopy in the treatment of kidney stone between 2 and 3 cm[J]. Prog Urol, 2011, 21(5): 327-332.
15.	方建明, 王可兵, 夏宏輝, 等. 輸尿管軟鏡聯合鈥激光碎石術治療腎和輸尿管上段結石: 附86例報告[J]. 中華腔鏡泌尿外科雜志: 電子版, 2012, 6(1): 42-45.

1. ?Khoder WY, Bader M, Sroka R, et al. Efficacy and safety of Ho: YAG laser lithotripsy for ureteroscopic removal of proximal and distal ureteral calculi[J]. BMC Urol, 2014(8;14): 62.
2. Cansino Alcaide JR, Reinoso Elbers J, López Sánchez D, et al. Flexible ureterorenoscopy (URS): technique and results[J]. Arch Esp Urol, 2010, 63(10): 862-870.
3. Tondut L, Peyronnet B, Arnaud A, et al. Impact of the acquisition of a flexible ureteroscope on the management of upper urinary tract stones in children[J]. Prog Urol, 2016, 26(2): 96-102.
4. Pan J, Chen Q, Xue W, et al. RIRS versus mPCNL for single renal stone of 2-3 cm: clinical outcome and cost-effective analysis in Chinese medical setting[J]. Urolithiasis, 2013, 41(1): 73-78.
5. 劉東亮, 朱蜀俠, 袁丹, 等. 輸尿管軟鏡聯合輸尿管硬鏡鈥激光碎石術治療復雜性輸尿管上段結石[J]. 四川醫學, 2015, 36(5): 632-635.
6. Bryniarski P, Paradysz A, Zyczkowski M, et al. A randomized controlled study to analyze the safety and efficacy of percutaneous nephrolithotripsy and retrograde intrarenal surgery in the management of renal stones more than2cm in diameter[J]. J Endourol, 2012, 26(1): 52-57.
7. 葉利洪, 李雨林, 李王堅, 等. 腎下盞解剖結構對輸尿管軟鏡下鈥激光碎石治療腎下盞結石療效的影響[J]. 中華泌尿外科雜志, 2013, 34(1): 24-27.
8. 楊嗣星, 宋超, 劉凌琪, 等. 輸尿管鏡下鈥激光碎石與經皮腎鏡取石術治療腎結石的療效比較[J]. 中華泌尿外科雜志, 2013, 34(9): 666-669.
9. Buscarini M, Conlin M. Update on flexible ureteroscopy[J]. Urol Int, 2008, 80(1): 1-7.
10. Herrera-Gonzalez G, Netsch C, Oberhagemann K, et al. Effectiveness of single flexible ureteroscopy for multiple renal calculi[J]. J Endourol, 2011, 25(3): 431-435.
11. 劉齊貴, 張文滔, 段娟, 等. 輸尿管軟鏡結合鈥激光治療腎結石的療效觀察[J]. 中國微創外科雜志, 2012, 12(3): 239-241.
12. Pasqui F, Dubosq F, Tchala K, et al. Impact on activescope deflection and irrigation flow of all endoscopic working tools during flexible uroterocopy[J]. Eur Urol, 2004, 45(1): 58-64.
13. Takazawa R, Kitayama S, Tsujii T. Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater[J]. Int J Urol, 2012, 19(3): 264-267.
14. Ben Saddik MA, Al-Qahtani Sejiny S, Ndoye M, et al. Flexible ureteroscopy in the treatment of kidney stone between 2 and 3 cm[J]. Prog Urol, 2011, 21(5): 327-332.
15. 方建明, 王可兵, 夏宏輝, 等. 輸尿管軟鏡聯合鈥激光碎石術治療腎和輸尿管上段結石: 附86例報告[J]. 中華腔鏡泌尿外科雜志: 電子版, 2012, 6(1): 42-45.

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West China Medical Journal

輸尿管軟鏡鈥激光碎石治療腎輸尿管上段結石150例

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