国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
INTERNATIONAL JOURNAL OF UROLOGY AND NEPHROLOGY
2013年
3期
320-322
,共3页
输尿管结石%碎石术,激光%激光,固体%通气机,负压
輸尿管結石%碎石術,激光%激光,固體%通氣機,負壓
수뇨관결석%쇄석술,격광%격광,고체%통기궤,부압
Ureteral Calculi%Lithotripsy,Laser%Lasers,Solid-State%Ventilators,Negative Pressure
目的 探讨有无负压吸引装置输尿管镜钬激光碎石术治疗输尿管上段结石的疗效.方法 分析本院2009年1月～2012年8月治疗的62例输尿管上段结石行钬激光碎石术患者的临床资料,所有患者入院前均留置肾造瘘管,其中20例为一期经皮肾取石术后输尿管残留结石的患者,35例为严重肾积水一期行经皮肾造瘘引流术的患者,7例为输尿管上端结石引起一侧肾感染留置肾造瘘管引流择期手术治疗的患者,根据入院顺序先后,随机分为两组,实验组为有负压吸引装置的输尿管镜下钬激光碎石术患者30例,对照组为无负压吸引装置的输尿管镜下钬激光碎石术患者32例,术中通过肾造瘘管测定肾盂压力的变化,术前及术后检测钠、钾的变化,记录手术时间及术后一周X片检查结石清除情况.结果 术中实验组肾盂压力为(93.46±3.56) cmH2O,对照组肾盂压力为(201.13±4.69) cmH2O,两组术中肾盂压力有显著性差异(P＜0.05).实验组手术时间(30±4.39)min,对照组为(50±5.28) min,术后第三天复查平片,实验组和对照组一次结石清除率分别为98.72％、90.25％,随访6个月,结石排净时间分别为(3±2.5)d、(15.3±9.8)d,术前术后两组患者电解质未见明显变化.结论 有、无负压吸引装置输尿管镜下钬激光碎石术对电解质无明显影响,但前者可明显降低术中肾盂压力,使视野清晰,减少结石上移,缩短手术时间,结石清除率高,减少因肾盂压力高而带来的并发症.
目的 探討有無負壓吸引裝置輸尿管鏡鈥激光碎石術治療輸尿管上段結石的療效.方法 分析本院2009年1月～2012年8月治療的62例輸尿管上段結石行鈥激光碎石術患者的臨床資料,所有患者入院前均留置腎造瘺管,其中20例為一期經皮腎取石術後輸尿管殘留結石的患者,35例為嚴重腎積水一期行經皮腎造瘺引流術的患者,7例為輸尿管上耑結石引起一側腎感染留置腎造瘺管引流擇期手術治療的患者,根據入院順序先後,隨機分為兩組,實驗組為有負壓吸引裝置的輸尿管鏡下鈥激光碎石術患者30例,對照組為無負壓吸引裝置的輸尿管鏡下鈥激光碎石術患者32例,術中通過腎造瘺管測定腎盂壓力的變化,術前及術後檢測鈉、鉀的變化,記錄手術時間及術後一週X片檢查結石清除情況.結果 術中實驗組腎盂壓力為(93.46±3.56) cmH2O,對照組腎盂壓力為(201.13±4.69) cmH2O,兩組術中腎盂壓力有顯著性差異(P＜0.05).實驗組手術時間(30±4.39)min,對照組為(50±5.28) min,術後第三天複查平片,實驗組和對照組一次結石清除率分彆為98.72％、90.25％,隨訪6箇月,結石排淨時間分彆為(3±2.5)d、(15.3±9.8)d,術前術後兩組患者電解質未見明顯變化.結論 有、無負壓吸引裝置輸尿管鏡下鈥激光碎石術對電解質無明顯影響,但前者可明顯降低術中腎盂壓力,使視野清晰,減少結石上移,縮短手術時間,結石清除率高,減少因腎盂壓力高而帶來的併髮癥.
목적 탐토유무부압흡인장치수뇨관경화격광쇄석술치료수뇨관상단결석적료효.방법 분석본원2009년1월～2012년8월치료적62례수뇨관상단결석행화격광쇄석술환자적림상자료,소유환자입원전균류치신조루관,기중20례위일기경피신취석술후수뇨관잔류결석적환자,35례위엄중신적수일기행경피신조루인류술적환자,7례위수뇨관상단결석인기일측신감염류치신조루관인류택기수술치료적환자,근거입원순서선후,수궤분위량조,실험조위유부압흡인장치적수뇨관경하화격광쇄석술환자30례,대조조위무부압흡인장치적수뇨관경하화격광쇄석술환자32례,술중통과신조루관측정신우압력적변화,술전급술후검측납、갑적변화,기록수술시간급술후일주X편검사결석청제정황.결과 술중실험조신우압력위(93.46±3.56) cmH2O,대조조신우압력위(201.13±4.69) cmH2O,량조술중신우압력유현저성차이(P＜0.05).실험조수술시간(30±4.39)min,대조조위(50±5.28) min,술후제삼천복사평편,실험조화대조조일차결석청제솔분별위98.72％、90.25％,수방6개월,결석배정시간분별위(3±2.5)d、(15.3±9.8)d,술전술후량조환자전해질미견명현변화.결론 유、무부압흡인장치수뇨관경하화격광쇄석술대전해질무명현영향,단전자가명현강저술중신우압력,사시야청석,감소결석상이,축단수술시간,결석청제솔고,감소인신우압력고이대래적병발증.
Objectives To comparre the therapeutic effect of ureteroscope with holmium laser lithotripsy combine with negative/non-negative pressure suction system.Methods The clinic data of 62 cases(from Jan.2009 to Aug.2012) of upper ureteral calculi by ureteroscope with holmium laser lithotripsy,before admission were indwelling nephrostomy fistula,twenty cases with residual ureteral calculi after percutaneous nephrolithotomy,35 patients with severe hydronephrosis were deal with nephrostomy drainage,and seven patients with upper ureteral calculi result in renal infection,62 cases underwent ureteroscope with holmium laser lithotripsy,In 30 cases(Group A) a negative pressure suction system was used.Without negative pressure suction system underwent in 32 patients(Group B).Renal fistula tube was connected with a urine dynamic detector.before and after operation test the Concentration of Na + and K +,record the time of operation,after 3 days,X-ray was used to test calculi.Results Operation was successfully completed in 62 patients,in group A,the average renal pelvic pressure was (93.46 ± 3.56)cmH2O,in group B,renal pelvic pressure was (201.13 ± 4.69)cmH2O,the two group have a significant difference(P ＜ 0.05),stone clearance rate was 98.72％,90.25 ％,there was no significant change in Na + and K + after operation.Conclusions Negative pressure suction system can reduce renal pelvic pressure,decrease the opportunity of fragments refluxed into the pelvis,had a positive meaning for decreasing the incidence of postoperational complications.
