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目的总结114例使用吸石测压输尿管扩张鞘配合钬激光治疗肾结石的临床经验。方法 2015年3~9月,使用专利吸石测压输尿管扩张鞘配合负压吸引装置联合输尿管软镜治疗114例肾结石患者。术中通过扩张鞘监测肾内压力,一边碎石一边吸石,于术后复查血液学检测指标,出院前复查腹部X线平片观察清石效果。结果术中初始肾内压力为5~24(9.1±2.55)mm Hg,手术全程肾内压力为-10~46(5.52±3.77)mm Hg,1例患者术后出现发热,96例(84.2%)患者术后复查腹部X线平片及超声提示结石基本清除干净。结论使用吸石测压输尿管扩张鞘配合输尿管软镜碎石,增加了手术安全性,减轻了患者术后排石负担,手术过程安全可行。
OBJECTIVE: To summarize the clinical experience of 114 cases of kidney stones treated with suction stone ureter dilatation and holmium laser. Methods From March to September 2015, 114 cases of kidney stones were treated with suction stone manometry ureteral dilatation sheath combined with negative pressure suction device and ureteroscope. Intraoperative renal pressure monitoring by dilatation of the sheath, while gravel suction side of the stone, postoperative follow-up hematological test indicators, check abdomen X-ray plain film before discharge to observe the stone effect. Results The intra-operative initial renal pressure was 5 to 24 (9.1 ± 2.55) mm Hg and the intra-renal pressure was -10 to 46 (5.52 ± 3.77) mm Hg during the operation. One patient developed fever after operation, 96 (84.2% ) Postoperative patients with recurrent abdominal X-ray and ultrasound showed that the basic removal of stones clean. Conclusions The use of suction stone ureteral dilatation sheath with ureteroscopic soft lithotripsy increases the safety of operation and relieves the postoperative burden of stone rowing. The surgical procedure is safe and feasible.