摘要
目的 评估英诺伟可拆卸式TMIVX-SC07输尿管管路封堵器在输尿管镜U-100双频双脉冲Nd∶ YAG碎石术中的安全性和拦截碎石效果.方法 对200例单侧输尿管结石患者于Wolf F6/7.5输尿管镜工作通道内安置可拆卸式英诺伟TMIVX-SC07管路封堵器.完全超越结石后操作体外手柄使叶片折叠成球状防止结石上移,拆卸手柄并退出输尿管镜后重新进境,将封堵器置于输尿管镜外尾部重新固定,而后使用激光碎石至小于2mm结石碎屑,然后使用封堵器叶片折叠球将结石碎片拖带出输尿管开口.所有患者术后留置F6双J管2～4周.结果 16例中重度积水的输尿管上段结石安置输尿管管路封堵器碎石后部分结石漂移至患侧肾内,2周后改用体外冲击波碎石或二期输尿管软镜碎石.术中无患者出现输尿管穿孔或输尿管黏膜撕脱.术后4周予腹部平片和B超等影像学随访,其中184例结石完全排除,结石清除率为92.0％.结论 可拆卸式输尿管管路封堵器联合双频双脉冲Nd∶ YAG激光能显著减少输尿管碎石术中结石漂移,提高结石清除率,手术安全性更高,有良好的应用前景.
Objectives To evaluate the clinical efficacy and safety of detachable INNOVEX TMIVX SC07 ureteral occlusion device in Ureteroscopic double-frequency double-pulse Nd∶ YAG Laser Lithotripsy.Methods 200 cases with unilateral ureteral calculi were enrolled in this study.Once the ureteral calculi was found by the ureteroscope,the INNOVEX TMIVX-SC07 ureteral occlusion device was inserted along with the hydrophilic guide wire in the working channel of the Wolf F6/7.5 ureteroscope.Detaching the hand shank of ureteral occlusion device,the operater drop out ureteroscope,and the occlusion device is laid aside in ureteral tube but out of ureteroscope.When the calculus were shredding up till 2 mm in diameter,the ureteral occlusion device was extracted slightly to remove the stone fragments.The pig tail stenting was realized in all the cases within 2 to 4 weeks.Results 16 cases in medium or serious renal hydrops using the ureteral occlusion device,the part of calculus was drifiting upside to the kidney,and then the flexible ureteroscope or extracorporal shockwave lithotripsy was used to shred the migrated stone.There were little peri-operative complications in our study,including ureteral perforate and ureteral membrane tear.The clinical review by the KUB and ultrasound carried out 4 weeks after the surgery.In 184 cases,there was no more significant residual calculus.The successful rate of the ureteroscopic laser lithotripsy with the ureteral occlusion device was 92.0%.Conclusions Combined the detachable INNOVEX TMIVX-SC07 ureteral occlusion device with double-frequency double-pulse Nd∶ YAG Laser Lithotripsy was very useful and safe in preventing the stone migration,and there is well-application prospect.
出处
《国际泌尿系统杂志》
2014年第2期183-185,共3页
International Journal of Urology and Nephrology
