输尿管软镜处理功能性独肾结石的临床疗效

张劲松; 石鑫; 杨嶠; 刘建和; 王光; 王辉涛; 叶淑华; 张恒

输尿管软镜处理功能性独肾结石的临床疗效

1. 昆明医科大学第二附属医院泌尿外科三病区
2. 云南省勐海县人民医院泌尿外科
3. 昆明医科大学第三附属医院资产管理部

基金项目:

基金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目 (2017FB049);

计量
- 文章访问数: 2711
- HTML全文浏览量: 721
- PDF下载量: 77
- 被引次数: 0
出版历程
- 收稿日期: 2017-04-21

Efficacy of Flexible Ureterorenoscopy in Treatment of Functional Kidney Stones

Funds:

基金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目 (2017FB049);

摘要

摘要: 目的探讨输尿管软镜处理功能性独肾结石的临床有效性和安全性, 评估输尿管软镜在微创性处理功能性独肾结石的应用价值.方法回顾性分析24例采用输尿管软镜钬激光碎石处理功能性独肾结石的患者的临床资料.全部患者中有男性19例, 女性5例.肾结石中功能性独肾结石最少的为1颗结石, 患者在全身麻醉下, 通过术前留置输尿管双J管2周后, 用输尿管软镜功能性独肾多发结石.手术结束后常规留置双J管.术后随访1个月, 复查CT, KUB和肾功能, 评估临床治疗效果.结果全部患者通过1次或者多次手术, 手术均顺利完成.22例患者术后结石全部取尽.单次手术时间59110 min, 平均74±19 min.1例发生感染性休克, 其他患者均无严重并发症发生, 术后结合随访肾功能正常或较术前有改善, 术后住院天数211 d.结论输尿管软镜处理功能性独肾结石是一种安全有效的方法, 能够保护肾功能, 具有临床推广应用价值.
- 输尿管软镜 /
- 功能性独肾 /
- 肾结石 /
- 疗效
Abstract: Objective To evaluate the clinical efficacy and safety of Flexible ureterorenoscopy in the treatment of functional solitary kindey stones, and evaluate the value of Flexible ureterorenoscopy in minimally invasive treatment of functional solitary kidney stones.Methods The clinical data of 24 patients with functional solitary kidney stones treated with Flexible ureterorenoscopy holmium laser lithotripsy in our hospital were analyzed retrospectively.All patients were 19 males and 5 females.Kidney stones in the function of multiple kidney stones at least one stone.Patients with functional kidney stones, patients under general anesthesia, preoperative indwelling ureter double J tube after 2 weeks, with soft ureteral function of multiple renal calculi.After the end of surgery conventional indwelling double J tube.All patients were followed up for 1 month.CT, KUB and renal function were reviewed and clinical therapeutic effect was evaluated.Results All the patients' operations ware completed successfully.No stone rate reached 92 %.A single operation time was from 59 to 110 minutes, with an average of (74±19) minutes.One male patients appeared septic shock, there was no serious complications in other patients, combining with follow-up after renal function.Postoperative renal function of patients was normal or improved than before.Postoperative hospital stay was 2 to 11 days.Conclusions Flexible ureterorenoscopy lithotripsy is a safe and effective method for the treatment of functional solitary kidney stones.It can protect renal function and has clinical application value
- Flexible ureterorenoscopy /
- Functional solitary kidney /
- Renal stones /
- Efficacy

HTML全文

参考文献(20)

[1]	[1]OW MOE.Kidney stones:pathophysiology and medical management[J].Lancet, 2006, 367 (9507) :333-344.
[2] 那彦群, 叶章群, 孙光, 等.中华泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社, 2014:129-140.
[3]石鑫, 李炯明, 陈戬.PNL并发肾出血的原因和防治进展[J].临床泌尿外科杂志, 2013, 28 (10) :790-793.
[4]	[4]OZDEN E, MERCIMEK M N.Percutaneous nephrolithotomy in pediatric age group:Assessment of effectiveness and complications[J].World J Nephrol, 2016, 5 (1) :84-89.
[5]	[5]KESSARIS D N, BELLMAN G C, PARDALIDIS N P.et al.Management of hemorrhage after percutaneous renal surgery[J].J Endourol, 1998, 12 (6) :509-512.
[6]	[6]S KITANO, Y ISO, M MORIYAMA, et al.Laparoscopy-assisted Billroth I gastrectomy[J].Surglaparosc Endosc, 1994, 4 (2) :146-148.
[7]程跃, 严泽军, 谢国海, 等.“粉末化碎石”在输尿管软镜治疗肾结石中的应用[J].微创泌尿外科杂志, 2013, 2 (3) :210-212.
[8]	[8]P DASGUPTA, MS CYNK, MF BULTITUDE, et al.Flexible ureterorenoscopy:prospective analysis of the Guy's experience[J].Ann R Coll Surg Engl, 2004, 86 (5) :367-370.
[9]孙颖浩, 戚晓升, 王林辉, 等.输尿管软镜下钬激光碎石术治疗肾结石 (附51例报告) [J].中华泌尿外科杂志, 2002, 23 (11) :681-682.
[10]段康, 麻伟青, 邝丽新, 等.测压吸石输尿管软镜引导鞘在输尿管软镜治疗肾结石中的应用[J].昆明医科大学学报, 2016, 37 (7) :86-92.
[11]	[11]REDDY S V, SHAIK A B.Outcome and complications of percutaneous nephrolithotomy as primary versus secondary procedure for renal calculi[J].Int Braz J Urol, 2016, 42 (2) :262-269.
[12] 石鑫, 李炯明, 刘建和.PCNL并发感染性休克的原因和防治进展[J].中华泌尿外科杂志, 2014, 35 (11) :873-875.
[13]	[13]KYRIAZIS I, PANAGOPOULOS V, KALLIDONIS P, et al.Complications in percutaneous nephrolithotomy[J].World Journal of Urology, 2014, 33 (8) :1-9.
[14]李涛, 董文培, 李瑞鹏, 等.输尿管软镜下钬激光碎石术后全身炎症反应综合征的临床分析[J].临床泌尿外科杂志, 2015, 30 (4) :356-358.
[15]程跃, 谢国海, 严泽军, 等.逆行输尿管软镜联合可视微通道经皮肾镜一期治疗鹿角形肾结石的临床分析[J].中华泌尿外科杂志, 2016, 37 (2) :127-130.
[16]樊长晖, 许长宝, 赵兴华, 等.输尿管软镜治疗并发肾功能不全肾结石患者的有效性及安全性分析[J].临床外科杂志, 2017, 25 (2) :116-119.
[17]林海利, 郑周达, 杨明根, 等.经皮肾镜与输尿管软镜在孤立肾结石的应用比较[J].中国微创外科杂志, 2016, 16 (4) :301-303.
[18]程永毅.输尿管软镜是否可以反复用于治疗大的肾结石[J].现代泌尿外科杂志, 2015, 2010 (10) :745-747.
[19]李健, 王健, 李应忠, 等.经尿道输尿管软镜碎石与微创经皮肾镜取石治疗肾盏结石的对比研究[J].昆明医科大学学报, 2015, 36 (3) :134-136.
[20]詹辉, 王剑松, 陈戬, 等.输尿管软硬镜结合钬激光碎石治疗较大肾及输尿管上段结石[J].昆明医科大学学报, 2017, 38 (1) :91-94.

相关文章(20)

[1]	滕芬, 田波, 李重熙, 金永梅, 陈海云, 刘俊. BIC/FTC/TAF单片方案真实世界临床疗效和安全性研究, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240411
[2]	陈韬, 张海燕, 袁顺辉, 李祥孟, 陈戬. 术前CL-11、尿亚硝酸盐、U-HBP与肾结石术后并发尿源性脓毒症的相关性及预警意义, 昆明医科大学学报.
[3]	陆小华, 袁洪新. BTLA、CTLA-4基因多态性与肝癌TACE联合靶向治疗疗效及预后相关性, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230927
[4]	李吉, 柯坤彬, 张白羽, 刘裔道, 白晶, 董滔, 王振丞, 秦德强, 王梦悦, 李颢. 云南德宏州傣族人群CaSR基因SNP与含钙肾结石和高钙尿的关联性, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230520
[5]	张四美, 房红梅, 杨晰宸, 宁蓉, 龙毅坚, 李蕊, 金亚菊. 双向折镜多维空间感觉刺激治疗脑卒中单侧忽略疗效观察, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20221224
[6]	李静玲, 柯坤彬, 王振丞, 秦德强, 李颢. CASR/VDR/PTH1R信号通路在含钙肾结石发生机制中的初步研究, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220609
[7]	张恒, 张劲松, 邢雷, 熊波波. 输尿管软镜碎石术在孤立肾与非孤立肾结石中的临床分析, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210224
[8]	熊波波, 张劲松, 王海峰, 左毅刚, 王剑松. 硕通镜联合钬激光治疗肾盂结石的临床疗效, 昆明医科大学学报.
[9]	詹辉, 王剑松, 陈戬, 柯昌兴, 丁明霞, 左毅刚. 输尿管软硬镜结合钬激光碎石治疗较大肾及输尿管上段结石, 昆明医科大学学报.
[10]	胡伟华. 氨溴索对老年慢性阻塞性肺病急性加重期的疗效对比, 昆明医科大学学报.
[11]	潘子鹏. 腹腔镜阑尾切除术治疗急性阑尾炎的临床疗效及其安全性评价, 昆明医科大学学报.
[12]	段先忠. 组合式输尿管软镜联合钬激光治疗肾结石72 例, 昆明医科大学学报.
[13]	段康. 测压吸石输尿管软镜引导鞘在输尿管软镜治疗肾结石中的应用, 昆明医科大学学报.
[14]	曾海萍. 超常规剂量氨溴索治疗慢性阻塞性肺疾病疗效及安全性的系统评价, 昆明医科大学学报.
[15]	马贵斌. 经尿道输尿管镜碎石联合膀胱微穿刺引流治疗小儿下尿路结石, 昆明医科大学学报.
[16]	刘月波. 小剂量美罗华治疗原发免疫性血小板减少症的临床疗效观察, 昆明医科大学学报.
[17]	胡海燕. 酸性氧化电位水治疗压疮等难愈性创面疗效分析, 昆明医科大学学报.
[18]	陶志兴. 钬激光与气压弹道碎石术治疗肾结石的临床疗效比较, 昆明医科大学学报.
[19]	柯坤彬. 经12肋下完全无管化经皮肾镜碎石术治疗肾上盏结石, 昆明医科大学学报.
[20]	. 复方莪术油栓月经后用药巩固治疗细菌性阴道炎疗效观察, 昆明医科大学学报.