CAJ | 학술논문

目的：探讨输尿管软镜处理肾结石术后结石残留的原因。方法2010年1月～2013年12月，采用输尿管软镜处理肾结石215例，其中术后结石残留32例，分析影响疗效的因素。结果32例结石残留原因中肾盂肾盏夹角＜30°17例，结石脓苔包裹3例，术中未找到结石2例，肾盏颈细长2例，5例因结石负荷较大引起输尿管石街，其余3例考虑多因素引起。术后结石分析提示草酸钙结石22例，胱氨酸结石3例，一水草酸钙与碳酸磷灰石混合结石5例，尿酸结石2例。结论结石残留主要影响因素有肾盂肾盏结构、结石负荷、结石成分及结石有无脓苔包裹。选取适宜的肾结石患者，术中针对可能造成排石困难的各种不利因素采取相应措施，是提高输尿管软镜碎石术结石清除率的关键。
목적：탐토수뇨관연경처리신결석술후결석잔류적원인。방법2010년1월～2013년12월，채용수뇨관연경처리신결석215례，기중술후결석잔류32례，분석영향료효적인소。결과32례결석잔류원인중신우신잔협각＜30°17례，결석농태포과3례，술중미조도결석2례，신잔경세장2례，5례인결석부하교대인기수뇨관석가，기여3례고필다인소인기。술후결석분석제시초산개결석22례，광안산결석3례，일수초산개여탄산린회석혼합결석5례，뇨산결석2례。결론결석잔류주요영향인소유신우신잔결구、결석부하、결석성분급결석유무농태포과。선취괄의적신결석환자，술중침대가능조성배석곤난적각충불리인소채취상응조시，시제고수뇨관연경쇄석술결석청제솔적관건。
Objective To investigate the cause of residual stones after flexible ureteroscopy for renal calculi. Methods We retrospectively assessed 215 cases of renal calculi treated by flexible ureteroscopic lithotripsy between January 2010 and December 2013,and analyzed 32 cases of residual stones after operation. Results Among the 32 cases,the angle of renal pelvis and calyces was less than 30°in 17 cases,stones were covered by pus in 3 cases,stones were unable to find in 2 cases,tenuous calyx neck existed in 2 cases,overburdened stones caused ureter stone-street in 5 cases,and the left 3 cases were caused by multiple factors.The stone analysis showed calcium oxalate stones (22 cases),cystine stones (3 cases),calcium oxalate monohydrate mixed with carbonate apatite stones (5 cases)and uric acid stone (2 cases),respectively. Conclusions The main factors of residual stones include the structure of renal pelvis and calyces,stone size,stone compositions,and stones covered by pus or not.The key to improve the stone free rate of flexible ureteroscopic lithotripsy is choosing appropriate patients and taking appropriate measures to handle the various adverse factors mentioned above.