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目的:探讨国产组合式输尿管纤维软镜用于诊治上尿路疾病的有效性和安全性。方法:回顾性分析2013年4月~2015年6月使用国产组合式输尿管纤维软镜完成的185例上尿路疾病手术的临床资料。其中上尿路结石171例,血尿待查9例,肾内占位性病变2例,多囊肾2例,肾盂旁囊肿1例;上尿路结石中最大直径0.8~4.5cm,平均1.83cm。手术方法先以输尿管硬镜行输尿管镜检,然后置入国产组合式输尿管纤维软镜,行软镜下镜检术或碎石术,如行多囊肾或肾盂旁囊肿手术,则采用软镜下钬激光囊肿内切开术。结果:185例病例中有178例行一期输尿管软镜手术,其中包括输尿管软镜钬激光碎石术165例、输尿管软镜镜检术10例和输尿管软镜下囊肿内切开术3例。该组病例无输尿管穿孔撕脱、大出血、脓毒血症等严重并发症发生。随访3个月见输尿管结石清除率为96.3%,肾脏多发性和下盏结石的清除率80.4%,肾盂和肾脏上、中盏结石清除率为93%;多囊肾和肾盂旁囊肿病例未见内切开的囊肿复发。结论:我们认为应用国产组合式输尿管纤维软镜能有效、安全地处理大部分上尿路疾病,是对现有国内进口软镜产品的补充,值得临床使用和推广。
Objective: To investigate the effectiveness and safety of domestic ureteral fibrinolyscopy in the diagnosis and treatment of upper urinary tract diseases. Methods: A retrospective analysis of the clinical data of 185 cases of upper urinary tract diseases performed by domestic combined ureterofibular soft-lens was performed from April 2013 to June 2015. Of which 171 cases of upper urinary tract stones, 9 cases of hematuria to be investigated, 2 cases of renal space-occupying lesions, 2 cases of polycystic kidney disease, 1 case of renal plexus cyst; upper urinary tract stones in the largest diameter of 0.8 ~ 4.5cm, an average of 1.83cm . Surgical approach first ureteroscopy ureteroscopy, and then into the domestic combination of ureteral fibers, soft-lens microscopy or lithotomy, such as polycystic kidney or renal plexus cyst surgery, the use of soft-mirror Under holmium laser cyst incision. Results: Of the 185 cases, 178 cases underwent one-stage ureteroscopic surgery, including 165 ureteroscopic holmium laser lithotripsy, ureteroscopic microscopy in 10 cases and ureteroscopic cystotomy in 3 cases . The group of patients without perforation of ureter avulsion, bleeding, sepsis and other serious complications. Follow-up of 3 months to see the ureteral stone clearance rate of 96.3%, multiple renal and lower calyceal clearance rate was 80.4%, renal pelvis and kidney, middle calculus stone clearance was 93%; polycystic kidney and plexus cyst cases did not Internal resection of the cyst recurrence. Conclusion: In our opinion, the application of domestic combined ureteral fibrinolysis can effectively and safely treat most of the upper urinary tract diseases. It is a supplement to the existing imported soft-lens products and is worthy of clinical use and promotion.