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中华腔镜泌尿外科杂志(电子版)

中华腔镜泌尿外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (03) : 200 -203. doi: 10.3877/cma.j.issn.1674-3253.2020.03.010

所属专题： 文献；

临床研究

电子输尿管软镜联合U100Plus激光治疗上尿路2～3 cm结石的疗效研究
徐巍1, 黄晨2, 赖德辉2,†(), 盛明2, 徐桂彬2, 杨炜青2, 李协照2, 李逊3   
  1. 1. 510700　广州中医药大学金沙洲医院泌尿外科
    2. 510700　广州医科大学附属第五医院泌尿外科；510700　广州医科大学微创外科新技术和产品转化中心
    3. 510700　广州中医药大学金沙洲医院泌尿外科；510700　广州医科大学附属第五医院泌尿外科；510700　广州医科大学微创外科新技术和产品转化中心
  • 收稿日期:2019-05-30 出版日期:2020-06-01
  • 通信作者: 赖德辉

Digital flexible ureteroscope combined with U100Plus laser in the treatment of 2-3 cm upper urinary calculi

Wei Xu1, Chen Huang2, Dehui Lai2,†(), Ming Sheng2, Guibin Xu2, Weiqing Yang2, Xiezhao Li2, Xun Li3   

  1. 1. Department of Urology, Jinshazhou Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510700, China
    2. Department of Urology, the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 510700, China; Department of Urology, Minimally Invasive Technology and Product Translational Center, Guangzhou Medical University, Guangzhou 510700, China
    3. Department of Urology, Jinshazhou Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510700, China; Department of Urology, the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 510700, China; Department of Urology, Minimally Invasive Technology and Product Translational Center, Guangzhou Medical University, Guangzhou 510700, China
  • Received:2019-05-30 Published:2020-06-01
  • Corresponding author: Dehui Lai
  • About author:
    Corresponding author:Lai Dehui, Email:
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徐巍, 黄晨, 赖德辉, 盛明, 徐桂彬, 杨炜青, 李协照, 李逊. 电子输尿管软镜联合U100Plus激光治疗上尿路2～3 cm结石的疗效研究[J]. 中华腔镜泌尿外科杂志(电子版), 2020, 14(03): 200-203.

Wei Xu, Chen Huang, Dehui Lai, Ming Sheng, Guibin Xu, Weiqing Yang, Xiezhao Li, Xun Li. Digital flexible ureteroscope combined with U100Plus laser in the treatment of 2-3 cm upper urinary calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(03): 200-203.

目的

探讨电子输尿管软镜联合U100Plus激光治疗上尿路2～3 cm结石的安全性及有效性。

方法

回顾性分析广州中医药大学金沙洲医院及广州医科大学附属第五医院2018年2月至2018年6月应用电子输尿管软镜结合U100Plus腔内激光碎石系统治疗66例上尿路2～3 cm结石的临床资料，记录术后1个月结石清除率，观察手术效果及围手术期并发症（Clavin-Dindo分级）情况。

结果

平均结石直径（2.3±0.3）cm，单次碎石成功率100%。平均碎石时间（56±24） min，平均术后住院时间（2.3±1.2）d。术后1个月结石清除率为87.9%。手术并发症发生率为9.09%（6例），其中Ⅰ级4例，3例术后体温>38.5℃，1例反复疼痛需镇痛；ⅢA级2例，术后1个月形成输尿管石街，再次手术清石。

结论

电子输尿管软镜联合U100Plus激光治疗上尿路2～3 cm结石，碎石效率高，并发症少，结石清除率高。

关键词: 输尿管软镜, U100Plus激光, 结石, 结石清除率
Objective

To evaluate the efficacy and safety of digital flexible ureteroscope combined with U100Plus laser in the treatment of 2-3 cm upper urinary calculi.

Methods

The clinical data of 66 patients with 2-3 cm upper urinary tract calculi treated by digital flexible ureteroscope combined with U100Plus laser lithotripsy from February to June 2018 in Jinshazhou Hospital of Guangzhou University of Chinese Medicine and the Fifth Hospital of Guangzhou Medical University were retrospectively analyzed. The stone free rate in one month after operation was calculated, and the outcome of operation were observed, as well as complications (Clavin-Dindo classification).

Results

The mean diameter of stones were (2.3±0.3) cm, and the success lithotripsy rate of single-stage was 100%. The average time of lithotripsy was (56±24) min, and postoperative hospital stay was (2.3±1.2) days. The stone free rate (SFR) was 87.9% after one month. The incidence of surgical complications was 9.09% (6 cases), including Grade I in 4 cases, 3 cases had fever (>38.5℃), and one required analgesia for recurrent pain. 2 cases had ureteral steinstrasse (Grade IIIA) were performed ureteroscopic procedure to remove the stone.

Conclusion

Digital flexible ureteroscope combined with U100Plus laser in the treatment of 2-3 cm upper urinary calculi has high lithotripsy efficiency, fewer complications and high stone clearance rate.

Key words: Flexible ureteroscope, U100Plus laser, Calculi, Stone free rate
表1 本组66例上尿路结石患者结石成分分析
结石成分 例数
一水草酸钙 28
尿酸 04
六水磷酸镁铵 02
一水草酸钙、二水草酸钙 04
一水草酸钙、尿酸 04
一水草酸钙、碳酸磷灰石 04
碳酸磷灰石、六水磷酸镁铵 02
一水草酸钙、二水草酸钙、碳酸磷灰石 18
[1]
Van Cleynenbreugel B, Kilic O, Akand M. Retrograde intrarenal surgery for renal stones - Part 1[J]. Turk J Urol, 2017, 43(2): 112-121.
[2]
刘玉辉, 王秀敏, 叶盛, 等. U100Plus激光治疗胆囊嵌顿结石效果分析[J]. 天津医药, 2014, 42(3): 278-279.
[3]
姜有涛, 张宇, 倪泽, 等. 新型组合式输尿管软镜结合U100激光治疗复杂性上尿路结石的初步体会[J]. 中国内镜杂志, 2013, 19(1): 88-90.
[4]
Berardinelli F, De Francesco P, Marchioni M, et al, Infective complications after retrograde intrarenal surgery: a new standardized classification system[J]. Int Urol Nephrol, 2016, 48(11): 1757-1762.
[5]
中华医学会泌尿外科分会与中国泌尿系结石联盟, 软性输尿管镜术中国专家共识[J]. 中华泌尿外科杂志, 2016, 37(8):561-565.
[6]
韦巍, 黄剑华, 钟羽翔, 等. 2～3 cm肾结石的CT值对输尿管软镜碎石效果的预估价值[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2019, 35(3): 235-237.
[7]
刘杰, 白大应, 石磊, 等. 输尿管软镜与微通道经皮肾镜治疗2～3 cm肾结石的对照研究[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2018, 25(6): 254-255.
[8]
Binbay M, Yuruk E, Akman T, et al. Is there a difference in outcomes between digital and fiberoptic flexible ureterorenoscopy procedures?[J]. J Endourol, 2010, 24(12): 1929-1934.
[9]
包强辉, 陈武, 陈艳华, 等. U100plus双频双脉冲激光在输尿管结石治疗中的应用[J]. 医疗装备, 2017, 37(6): 212-213.
[10]
吴越, 张国飞, 邓玮, 等. U100Plus双频双脉冲激光在输尿管结石治疗中的应用[J]. 中国微创外科杂志, 2012, 23(8): 564-565
[11]
Eric Fuh 1, George E Haleblian, Regina D Norris, et al. The effect of frequency doubled double pulse nd:yag laser fiber proximity to the target stone on transient cavitation and acoustic emission[J]. Norris, 2007, 177(4): 1542-1545.
[12]
Zorcher T, Hochberger J, Schrott KM,et al. In vitro study concerning the efficiency of the frequency-doubled double-pulse Neodymium:YAG laser (FREDDY) for lithotripsy of calculi in the urinary tract[J]. Lasers surg med, 1999, 25(1): 38-42.
[13]
Dubosq F, Pasqui F, Girard F, et al. Endoscopic lithotripsy and the FREDDY laser: initial experience[J]. J Endourol, 2006, 20(5): 296-299.
[14]
Ebert A, Stangl J, Kuhn R, et al. The frequency-doubled double-pulse Neodym:YAG laser lithotripter (FREDDY) in lithotripsy of urinary stones. First clinical experience [J]. Urologe A, 2003, 42(6): 825-833.
[15]
Marguet CG, Sung JC, Springhart WP, et al. In vitro comparison of stone retropulsion and fragmentation of the frequency doubled, double pulse nd:yag laser and the holmium:yag laser[J]. J Urol, 2005. 173(5): 1797-1800.
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