摘要
目的观察女性肾上盏结石2.0~3.0 cm患者接受智能监控肾盂压力的输尿管硬镜吸引取石术的效果。方法纳入2018年5月至2020年12月赣州市人民医院泌尿外科就诊的女性肾上盏结石2.0~3.0 cm患者31例,使用6.0/7.5F小儿输尿管硬镜行智能监控肾盂压力的输尿管硬镜吸引取石术,术中肾盂压力控制值为-15~5 mmHg、腔内压力警戒值为30 mmHg、灌注流量为50~150 ml/min,采用550μm钬激光光纤碎石,钬激光能量设定为1.0~2.0 J,20~30 Hz。观察患者手术效果及术后并发症。结果患者结石最大直径为20.1~29.6 mm,平均(24.62±6.35)mm,2例患者因输尿管狭窄置二期手术,4例患者术中完全改用输尿管软镜碎石,手术时间为61.0~87.4 min。27例患者成功实施智能监控肾盂压力的输尿管硬镜吸引取石术,其中5例术中部分联合使用输尿管软镜,手术时间(38.21±12.91)min,术后1个月复查结石清石率96.30%(26/27),1例残留结石患者行体位冲击波碎石。根据术后并发症Clavien-Dindo分级标准:Ⅰ级1例,Ⅱ级1例,无Ⅲ~Ⅴ级患者。结论采用智能监控肾盂压力的输尿管硬镜吸引取石术治疗女性2.0~3.0 cm肾上盏结石具有较高结石清除率,且并发症少。
Objective This study aimed to observe the effects of suctioning ureteroscopic lithotriptomy with intelligent control of renal pelvic pressure in the treatment of upper calyceal calculi of 2.0-3.0 cm in women.Methods From May 2018 to December 2020,31 female patients with upper calyceal calculi of 2.0-3.0 cm were enrolled in the Department of Urology of Ganzhou People’s Hospital.A rigid ureteroscope was used to perform suctioning ureteroscopic lithotriptomy.The intraoperative renal pelvis pressure control value was-15-5 mm Hg.The intracavity pressure warning value was 30 mm Hg.The perfusion flow was 50-150 ml/min for 550μm holmium laser fiber lithotripsy.The energy was set at 1.0-2.0 J,20-30 Hz.The results of the operations and postoperative complications were observed.Results The maximum diameter of the calculi ranged from 20.1 mm to 29.6 mm,with an average of(24.62±6.35)mm.Two patients underwent a secondary operation for ureteral strictures,and four patients underwent flexible ureteroscopic lithotriptomy,with operation times ranging from 61.0 min to 87.4 min.A total of 27 patients were successfully operated on with intelligent control of renal pelvic pressure,in which five patients received combined flexible ureteroscopy.The operation time was(38.21±12.91)min.The stone free rate was 96.30%(26/27)after 1 month,and one patient with a residual stone underwent shock wave lithotripsis.According to the Clavien-Dindo grading criteria for postoperative complications,one case was gradeⅠ,one case was gradeⅡ,and no cases were gradeⅢorⅤ.Conclusion Suctioning ureteroscopic lithotriptomy with intelligent control of renal pelvic pressure in the treatment of upper calyceal calculi of 2.0-3.0 cm in women results in a higher stone free rate and fewer complications.
作者
邓小林
张红生
宋乐明
黄鑫
刘泰荣
彭作锋
Deng Xiaolin;Zhang Hongsheng;Song Leming;Huang Xin;Liu Tairong;Peng Zuofeng(Department of Urology,Ganzhou People’s Hospital,Ganzhou,Jiangxi,341000,China;Department of Urology,Ningdu County People’s Hospital,Ganzhou,Jiangxi,341000,China)
出处
《泌尿外科杂志（电子版）》
2021年第4期67-69,73,共4页
Journal of Urology for Clinicians(Electronic Version)
关键词
肾上盏结石
女性
肾盂压力
智能监控
输尿管镜术
Upper calyceal calculi,female
Renal pelvis pressure
Intelligent control
Ureteroscopy
