逆行输尿管软镜联合可弯曲负压吸引鞘治疗>2 cm肾结石的疗效观察

【摘要】 目的 探讨逆行输尿管软镜联合可弯曲负压吸引鞘治疗>2 cm肾结石的安全性、可行性及疗效。方法 回顾性分析2021年11月至2023年5月68例采用输尿管软镜联合可弯曲负压吸引鞘治疗>2 cm肾结石患者的临床资料。评估结石清除率及并发症等情况。结果 结石长径2.1～3.7(2.56±0.55)cm,CT值638～1485(929.2±286.9)Hu。一次进镜成功率100%，手术时间50～170(95.4±27.9)min。术后4周总结石清除率88.24%，其中结石长径2～3 cm组清除率93.88%,>3 cm组清除率73.68%。术后总并发症发生率2.94%，其中结石长径2～3 cm组并发症发生率2.04%,>3 cm组并发症发生率5.26%。2例均为术后高热，经抗感染治疗后好转。所有患者无大出血、脏器损伤等并发症发生。结论 逆行输尿管软镜联合可弯曲负压吸引鞘治疗>2 cm肾结石是安全可行的，且并发症少，临床疗效确切，可在临床推广应用。更多还原

【Abstract】 Objective To evaluate the safety,feasibility and clinical efficacy of flexible ureteroscopy combined with flexible vacuum aspiration ureteral access sheath lithotripsy for renal stones larger than 2 cm.Methods The clinical data of 68 patients who underwent flexible ureterscope combined with flexible vacuum aspiration ureteral access sheath to treat renal stones with a size of larger than 2cm from Nov 2021 to May 2023 were retrospectively analyzed.The stone free rate and complications were evaluated 4 weeks after the operation.Results The renal stones size was 2.1～3.7 cm,with an average of(2.56±0.55)cm.CT value of stones was 638～1,485 Hu,with an average of(929.2±286.9)Hu.The success rate of the ureteroscopic insertion was 100%.The operation time was 50～170 min,with an average of(95.4±27.9)min.The total postoperative stone free rate was 88.24%,including 93.88% in the 2～3 cm group and 73.68% in the ≥3cm group.However,the total complication rate was 2.94%,including 2.04% in the 2～3 cm group and 5.26% in the ≥3 cm group.Post-operative high fever occurred in two cases,which improved after anti-infection treatment.No complications such as massive hemorrhage and organ injury occurred in all cases.Conclusion The flexible ureterscopy with flexible vacuum aspiration ureteral access sheath lithotripsy is safe,feasible,minimal invasive and effective in the treatment of renal stones larger than 2 cm.更多还原