侧斜头低截石位行输尿管镜治疗输尿管上段结石

Treatment of upper ureteral calculi by an ureteroscopy approach in a low-head lithotomy with right or left lateral tilt

摘要:

目的 探讨在输尿管镜取石术中应用侧斜头低截石位的效果。方法 回顾性分析2009年9月-2015年5月采用侧斜头低截石位运用输尿管硬镜钬激光治疗110例输尿管上段结石患者的临床资料。结果 该组患者的手术效果均较满意，91例患者Ⅰ期碎石成功，Ⅰ期碎石率为82.7%；56例患者结石上移至肾盂或上盏；14例患者残余结石，行体外震波碎石治疗成功；3例患者输尿管狭窄，留置双J管2周后Ⅱ期手术期碎石成功。2例患者术中转经皮肾镜碎石取石成功。手术用时为20～58 min，平均35 min；住院时间为5～7 d，平均住院天数为6 d。结论 在输尿管镜取石术治疗输尿管上段结石时采用侧斜头低截石位，安全有效，提高了碎石的成功率，是输尿管镜取石术治疗输尿管上段结石的理想体位。

Abstract:

ObjectiveTo evaluate the methods in treatment of upper urinary calculi in a low-head lithotomy with right or left lateral tilt by an ureteroscopy approach. Methods From September 2009 to May 2015, 110 patients with upper ureteral calculi (after failed ESWL) were underwent holmium laser lithotripsy by a ureteroscopy approach in a low-head lithotomy with right or left lateral tilt. Their clinical data and complications were analyzed retrospectively. Results Surgical effect of patients was satisfied with the success of gravel 91 patients, with a total rate of 82.7 % gravel. Conclusion Low-head lithotomy with right or left lateral tilt is a good body position to perform ureteroscopic lithotripsy for upper ureteral calculi. It is safe and effective.