摘要
目的 探讨输尿管软镜鞘外持续引流技术在输尿管软镜碎石术中应用,对预防术后尿源性感染导致的全身炎症反应综合征的作用.方法 回顾性分析2015年5月至2016年3月55例输尿管软镜碎石术.术中使用4F输尿管导管于输尿管软镜鞘外持续引流减轻肾盂压力,使用钬激光10 ~12 Hz,0.8～1.2 J,尽量将结石击碎至0.1 ～0.2 mm,碎石过程以手压法低速冲洗,较大残石者以网篮取出,检视无大于2 mm残石后留置双J管及尿管.结果 手术时间为52 ～108 min,平均（64±15） min;碎石时间为25 ～52 min,平均（40.3±8.5）min,术中无明显出血,术中术后生命体征平稳,无寒战、发热、败血症、感染性休克等并发症,出院前1d复查泌尿系平片,提示均未见有意义结石碎片残留,术后住院时间平均为2～5d,平均（2.3±0.5）d.术后3～4周返院复查取出D-J管.结论 本研究初步表明,使用输尿管软镜鞘外持续引流术后相关感染发生率低,手术过程安全,碎石效果良好.
Objective To evaluate the validity of constant drainage outside the ureteric access sheath and preventing postoperative SIRS in flexible ureteroscopy and laser lithotripsy.Methods From May 2015 to March 2016,a total of 55 patients were treated by flxible ureteroscopy and laser lithotripsy in our hospital.Constant drainage outside the ureteric access sheath by a 4F ureteral catheter was performed during the operation to decrease the pressure of the renal pelvis.Holmium laser（10 ～ 12 Hz,0.8 ～ 1.2 J）was used to perform laser lithotripsy.Calculi were comminuted to less than 2 mm,or removed with reticular basket.Double-J stent and a ureter catheter would be setup in the end of the procedure.Results The operation time was 52 ～ 108 min,mean （64 ± 15） min,and the lithotripsy stay was 25 ～ 52 min,mean （40.3 ± 8.5） min.All operations were performed successfully with less bleeding,no fever and no hematosepsis in the patients after the operations.No residual stones were detected by KUB one day before discharged.The average time in hospital after operation was（2.3 ± 0.5） days.And the Double-J stents were removed in 3 ～ 4 weeks after operation.Conclusions Constant drainage outside the ureteric access sheath is a safe and effective procedure in flexible ureteroscopy for less infection complication.
出处
《国际泌尿系统杂志》
2018年第1期89-91,共3页
International Journal of Urology and Nephrology
关键词
输尿管结石
输尿管镜
碎石术
Ureteral Calculi
Ureteroscopes
Lithotripsy
