负压组合镜联合输尿管软镜治疗2~3 cm肾结石的疗效观察

doi:10.19558/j.cnki.10-1020/r.2020.03.004

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摘要 目的： 探讨负压组合镜联合输尿管软镜治疗2~3 cm肾结石的安全性和有效性。方法： 2017年7月–2019年9月采用负压组合镜联合输尿管软镜治疗2~3 cm肾结石患者60例。所有患者均为单侧肾结石,结石大小2.1~3.0 cm,平均（2.6±0.2）cm。分析其结石清除率（SFR）、手术总体时间、围手术期并发症等临床资料。结果： 56例（93.3%）患者成功行负压组合镜联合输尿管软镜碎石取石手术,4例（6.7%）患者因留置镜鞘失败改行经皮肾镜取石术。一期SFR为92.9%,手术总体时间39~107 min,平均（56.4±13.4）min。术后发热患者5例,无输尿管穿孔、严重血尿、严重脓毒血症及石街形成发生。结论： 负压组合镜联合输尿管软镜治疗2~3 cm肾结石安全有效,结石清除率高,并发症少,创伤小,患者术后恢复快。

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	李金
	刘伟
	郑亮亮
	王锶
	龚智娴
	邓君

关键词 ：输尿管软镜, 负压组合镜, 钬激光碎石术, 肾结石

Abstract：Objective： To explore the safety and efficacy of negative pressure composite ureteroscope combined with flexible ureteroscopy in the treatment of renal stones between 2 and 3 cm. Methods： From July 2017 to September 2019, 60 patients with 2-3 cm renal stones were treated with negative pressure composite ureteroscope combined with flexible ureteroscopy. All patients had unilateral renal stones with a stone diameter of 2.1 to 3.0 cm (mean, 2.6±0.2 cm). The clinical data including stone-free rate (SFR), total operation time and complications in perioperative period were analyzed. Results： 56 patients (93.3%) were successfully treated by negative pressure composite ureteroscope combined with flexible ureteroscopy, and 4 patients (6.7%) underwent percutaneous nephrolithotomy due to failure of indwelling ureteral access sheath. The SFR of the first stage was 92.9%, and the total operation time was 39.0 to 107.0 min (mean, 56.4±13.4 min). After operation, 5 patients developed fever, and no such complications as ureter perforation, severe hematuria, severe sepsis and stone street formation occurred. Conclusion： Negative pressure composite ureteroscope combined with flexible ureteroscopy is safe and effective in the treatment of renal stones between 2 and 3 cm. This method has the advantages of high SFR, less complications, less trauma and the patient recovers quickly after operation.

Key words： negative pressure composite ureteroscope ureteroscopy Holmium laser lithotripsy renal stones

收稿日期: 2019-09-12

ZTFLH:

R693.4

通讯作者: 邓君,dengjun2004@163.com

引用本文:

李金, 刘伟, 郑亮亮, 王锶, 龚智娴, 邓君. 负压组合镜联合输尿管软镜治疗2~3 cm肾结石的疗效观察[J]. 微创泌尿外科杂志, 2020, 9(3): 171-175.
LI Jin, LIU Wei, ZHENG Liangliang, WANG Si, GONG Zhixian, DENG Jun. Clinical efficiency of negative pressure composite ureteroscope combined with flexible ureteroscopy for the treatment of 2-3 cm renal stones. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(3): 171-175.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1591.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I3/171

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