可智能监控肾盂内压的输尿管软镜吸引取石术 治疗马蹄肾结石的疗效分析*

Efficacy of suctioning flexible ureteroscopy with automatic control of renal pelvic pressure treatment of horseshoe kidney stones*

摘要:

摘要：目的 探讨应用可智能监控肾盂内压的输尿管软镜吸引取石术在治疗马蹄肾结石中的可行性。方法 分析2016年6月－2018年3月对9例马蹄肾合并肾结石患者行输尿管软镜钬激光碎石术。术中应用自主研发的F12/F14可测量压力的输尿管软镜吸引鞘和医用灌注吸引平台智能监控肾盂内压。分析其手术时间、平均住院天数、清石率和并发症发生情况，术后1个月行CT或者腹部平片（KUB）检查评估清石率。结果 9例患者结石直径（1.8±0.7）cm，平均手术时间为（53.2±15.2）min，术后平均住院天数（2.5± 1.2）d，术后1个月一期清石率为88.89%，1例患者术后行体外冲击波碎石治疗也清石干净。术后1例患者出现腰疼，3例患者出现轻度血尿，对症治疗后症状缓解，术后无发热、输尿管穿孔、输尿管狭窄和输尿管撕脱等严重并发症。结论 可智能监控肾盂内压的输尿管软镜吸引取石术治疗马蹄肾安全有效，清石率高，并发症少。

Abstract:

Abstract: Objective To explore the feasibility of using soft ureteroscope to attract stones for the treatment of horseshoe kidney stones, which can intelligently monitor the internal pressure of the renal pelvis. Methods From June 2016 to March 2018, 9 cases of horseshoe kidney complicated with kidney stones were treated with ureteroscopic holmium laser lithotripsy. During the operation, a self-developed F12/F14 flexible ureteroscope suction sheath capable of measuring pressure and a medical perfusion suction platform were used to intelligently monitor the internal pressure of the renal pelvis. The operation time, average hospital stay, stone removal rate and complications were analyzed, and the stone removal rate was evaluated by CT or KUB examination 1 month after operation. Results The stone diameter of the 9 patients was about (1.8 ± 0.7) cm, the average operation time was (53.2 ± 15.2) min, the average hospital stay was (2.5 ± 1.2) d, and the stone clearance rate was 88.89% in the first month after operation. One patient underwent extracorporeal shock wave lithotripsy after operation, and the stone was also cleared. One patient suffered from lumbar pain and three patients suffered from mild hematuria after symptomatic treatment. No serious complications such as fever, perforation of ureter or stricture of ureter or avulsion of ureter occurred after the operation. Conclusion The soft ureteroscopic aspiration lithotomy, which can intelligently monitor the internal pressure of the renal pelvis, is safe and effective in the treatment of horseshoe kidney with high stone clearance rate and few complications.