输尿管镜联合结石封堵导管治疗输尿管上段结石.doc

输尿管镜联合封堵取石导管治疗输尿管上段结石的对比研究 蓝建华，唐金，唐贤富郑兴明，夏吉朴 广安市人民医院泌尿外科，四川广安 638000 [摘要] 目的：输尿管镜联合英诺伟 TMIVX-SC10/07封堵取石导管治疗输尿管上段结石的有效性及安全性。 方法：回顾性分析输尿管镜联合封堵取石导管配合钬激光治疗组（A组，40例）与输尿管镜配合钬激光治疗组（B组，35例）的手术时间、并发症、残石率及影响因素。 结果：两组碎石成功率主要与结石具体位置及有无息肉包裹相关，A组在手术时间及残石率方面明显优于B组，两组均无明显并发症。 结论：输尿管镜联合封堵取石导管，能够更有效治疗输尿管上段结石，特别是位于骶髂关节上缘- L3段结石。 [关键词] 封堵取石导管；钬激光碎石；输尿管镜 [中图分类号] R693．4 Comparison of ureteroscopic blocking innovex TMIVX-SC10/07 ureteral occlusion device in the treatment of Upper ureteral calculi LAN Jian-hua, TANG Pei-jin, TANG Xian-fu, XU xiao-han, ZHEN Xin-min, XIA Ji-pu Guangan City, Sichuan Province Peoples Hospital Department of Urology, Guangan 638000 [Abstract] Objective: To research effectiveness and safety of joint innovex TMIVX-SC10/07 ureteral occlusion device and ureteroscopy in the treatment of upper ureteral calculi. Methods: Retrospective analysis of innovex TMIVX-SC10/07 ureteral occlusion device and ureteroscopy with holmium laser group (A group, 40 cases) and ureteroscopy with holmium laser treatment group (B group, 35 cases) operative time, complications, and residual rate and influencing factors. Results: The success rate of the two groups mainly gravel and stones wrapped in the specific location and the presence of polyps related, A group in operation time and residual rate was superior in group B, the two groups had no significant complications. Conclusion: Joint innovex TMIVX-SC10/07 ureteral occlusion device and ureteroscopy can more effectively with upper ureteral stones, especially those located on the edge of the sacroiliac joint - L3 segments stones. [Key words] TMIVX-SC10/07 ureteral occlusion device; holmium laser lithotripsy; ureteroscopy 输尿管上段结石是一种较常见的泌尿系结石，随着腔镜微创技术的发展，绝大部分结石都能通过输尿管镜碎石、经皮肾镜碎石以及腹腔镜下输尿管切开取石等手术方式治疗[3]。对于输尿管上段结石，采用经皮肾镜碎石或腹腔镜下切开取石创伤常常较大，住院时间较长，而输尿管镜下钬激光碎石虽然较其他术式创伤小，但容易将结石冲人肾盂或碎石渣难以排除，往往不能达到预期效果[6]。近年来，我院引进一种封堵取石导管，联合输尿管镜并配合钬激光治疗输尿管上段结石，取得良好效果，现报道如下。 1 资料与方法 1．1 资料 回顾性分析2010年08月～2013年06月75例输尿管上段结石患者，早期使用输