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目的:比较三种结石封堵拦截装置(Stone-Cone,N-Trap,折叠式拦截器)在输尿管镜碎石术中预防结石逃逸和碎石清石的效果。方法:2013年11月~2014年10月,我院行输尿管镜钬激光碎石取石术治疗输尿管结石患者60例,并将患者随机平均分成三组,每组20例。第1组使用Stone-Cone,第2组使用N-Trap,第3组使用折叠式拦截器,比较三种结石封堵装置的特性、手术效果及术者使用体会。结果:第1组手术时间15~40(24.8±7.2)min,第2组手术时间20~35(26.3±5.1)min,第3组因发生结石上漂而更换输尿管软镜碎石,明显延长了手术时间。第1组和第2组均未发生结石逃逸,第3组有2例发生结石上漂入肾脏。三组留置单J管或无管的患者术后均无发热、肾绞痛等并发症发生。结论:输尿管镜钬激光碎石术根据具体情况使用不同的结石封堵拦截装置可安全有效地预防结石逃逸,避免了二次手术或ESWL,减少了输尿管支架的使用,缩短了住院时间。
OBJECTIVE: To compare the effectiveness of three stone blocking devices (Stone-Cone, N-Trap, foldable interceptor) in preventing stones from escaping and lithotripsy in ureteroscopic lithotripsy. Methods: From November 2013 to October 2014, 60 cases of ureteral calculi were treated with ureteroscopic holmium laser lithotripsy in our hospital. Patients were randomly divided into three groups (n = 20 in each group). Group 1 used Stone-Cone, Group 2 used N-Trap, Group 3 used a folding interceptor to compare the characteristics of the three stones occlusion device, the effect of surgery and the use of the surgeon. Results: The operative time of group 1 was 15-40 (24.8 ± 7.2) min and that of group 2 was 20-35 (26.3 ± 5.1) min. Group 3 was replaced by ureteroscopic soft lithotripsy due to floating of stones, which was significantly prolonged The operation time. No stones escaped in Group 1 and Group 2, and 2 cases of Group 3 stones had drifted into the kidney. There were no fever, renal colic, and other complications in the three groups of patients who were placed in a single J tube or tubeless operation. Conclusions: Ureteroscopic holmium laser lithotripsy can prevent the escaping stones safely and effectively by using different lithotripsy blocking devices according to the specific situations, avoiding secondary surgery or ESWL, reducing the use of ureteral stents and shortening the hospitalization time.