摘要
目的探讨封堵取石导管在输尿管镜下中上段输尿管结石钬激光碎石术中的应用价值。方法回顾性分析2013年9月至2015年8月合肥市第三人民医院收治的54例中上段输尿管结石患者,输尿管镜进镜至输尿管结石下方,置入封堵取石导管,叶片部位越过结石后收紧叶片呈球状,钬激光将结石击碎后将封堵取石导管叶片连同碎石缓慢拖入膀胱。结果49例碎石取石成功,无结石残留,清石率为90.7%。2例因患者术前行ESWL治疗输尿管水肿、出血较重,为避免输尿管穿孔放弃使用结石取石导管;1例因结石上段输尿管扩张明显,置入封堵取石导管时结石漂移至肾盂,留置双J管后ESWL治疗后结石排出;另2例因结石周围息肉包裹,置结石封堵取石导管困难,先行钬激光碎石,打出通道后置入封堵取石导管时,部分结石漂移至肾盂。结论封堵取石导管在输尿管镜钬激光治疗中上段输尿管结石中能有效避免结石漂移,残石率低,具有较高的临床应用价值。
Objective To evaluate the clinical efficacy of ureteral occlusion device in ureteroscopic for treatment of upper-middle ureteral calculi. Methods We reviewed the data of 54 cases with upper-middle ureteral calculi from September 2013 to August 2015,we treated with ureteroscopy into the bottom of ureteral calculi,then placed ureteral occlusion device,after the blade portion of the blade across the stone tighten spherical,holmium laser will be crushed stone after stone extraction duct occluder blade slowly dragged into the bladder along with gravel. Results 49 cases of lithotripsy success,no residual stones, stone clearance rate was 90.7%.In order to avoid ureteral perforation renounce,we gived up the use of ureteral occlusion device;one case the ureteral calculi migrated into renal pelvis when the ureteral occlusion device was placed,then the ureteral calculi discharged after indwelling double J tube and ESWL treatment.The other two cases with polyps wrapped around which placed ureteral occlusion device difficult,we first used holmium laser shot after passage into the conduit portion when the calculi drifted to the pelvis. Conclusion The ureteral occlusion device can effectively avoid migration with lower residual,It＇s very effective in holmium laser treatment of upper-middle ureteral calculi.
出处
《临床医学研究与实践》
2016年第2期15-16,共2页
Clinical Research and Practice
关键词
输尿管中上段结石
封堵取石导管
输尿管镜
upper-middle ureteral calculi
ureteral occlusion device
ureteroscopic
