可视球囊扩张导管在经皮肾镜取石术中的应用（附20例报告）

Clinical report of visual balloon dilation cathter for percutaneous nephrolithotripsy (20 cases)

摘要:

摘要：目的 评价可视球囊扩张在经皮肾镜取石术（PCNL）中的可行性和安全性。方法 回顾性分析2017年3月－2018年3月应用可视球囊扩张导管建立通道行PCNL的20例肾结石患者的病例资料。结果 20例均成功应用可视球囊建立皮肾通道，通道建立时间为5.0～13.5 min，平均（7.2±2.1）min，手术时间为30.0～120.0 min，平均（59.1±21.9）min。术后血尿（Clavien Ⅰ）2例，经保守治疗好转。发热（Clavien Ⅱ）1例，经抗生素治疗好转。1例残留结石行体外冲击波治疗。术后1个月无石率和手术成功率分别为90.00%和95.00%，术后3个月无石率为100.00%。结论 可视球囊有助于提高建立皮肾通道的准确性和提高手术成功率。

Abstract:

Abstract: Objective To evaluate the feasibility and safety of self-made optical balloon dilator for percutaneous nephrolithotomy (PCNL) in treatment of renal calculi. Methods There were 20 patients underwent PCNL with self-made device for the tract establishment from March 2017 to March 2018, 12 cases of male and 8 cases of female. The mean±SD (range) patients’ age was 26 ~ 73 (47.8 ± 12.7) years, stone volume was 2.0 ~ 3.5 (2.5 ± 0.4) cm and stone density was 579 ~ 1247 (978.7 ± 221.6) HU. The factors analysed were demographic variables including age, sex, stone volume, stone density (HU) and stone location, and intra-and peri-operative variables such as operating time, drop in haemoglobin level, stone clearance and complications. Results All tracts were successfully developed with the optical nephrostomy balloon dilator. Tract development time was 5.0 ~ 13.5 (7.2 ± 2.1) min, and operation time was 30 ~ 120 (59.1 ± 21.9) min. Two patients who suffered hematuria (Clavien I) underwent conservative treatment and recovered well. Hemoglobin decrease was 3.4 ~ 10.4 (5.5 ± 1.8) g/L, and hospital time was 4 ~ 7 (5.1 ± 0.9) d. No patient required blood transfusion. There were no major complications, the respective stone free and success rate at the first month after operation was 90.00% (18/20) and 95.00%(19/20), and at the third month after operation was both 100.00%. One patient underwent ESWL and the fragments was discharged at 3 months follow up. Conclusion Optical balloon facilitate accurately developing tract and improving surgery success rate.