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国产一次性电子输尿管软镜在上尿路结石治疗中的初步应用经验

Initial experience of domestic disposable digital flexible ureteroscope in the treatment of upper urinary tract stones

摘要:

目的:总结国产一次性电子输尿管软镜在上尿路结石治疗中的初步应用经验。方法:回顾性分析2020年2—3月北京清华长庚医院收治的16例上尿路结石患者的临床资料。男10例,女6例。平均年龄42.1(26~63)岁。2例既往有结石内镜治疗手术史。输尿管上段结石12例,肾结石4例。结石平均直径1.3(0.8~2.1) cm。4例术前预先留置输尿管支架管。手术均采用国产一次性电子输尿管软镜。软镜由手柄和镜体两部分组成,可通过手柄后端传输线与成像主机连接实现图像转投功能。16例术中使用输尿管鞘规格分别为F12/14 4例,F11/13 10例,F10/12 2例。术中使用200 μm光纤配合钬激光进行碎石。8例术中使用取石网篮。术后常规留置F6输尿管支架管2~4周。记录手术时间、术后并发症、住院时间、结石清除率等情况。结果:本组16例中,14例一期手术成功,2例因输尿管较细,置鞘失败后留置输尿管支架管改行二期手术。平均手术时间55.6(32~115) min。平均激光碎石时间25.2(10~65) min。术中均未出现软镜损坏情况。术后患者均恢复良好,无发热、疼痛等术后并发症。2例术后接受物理排石治疗。平均住院时间1.2(1~3) d。术后1个月结石清除率为87.5%(14/16)。结论:国产一次性电子输尿管软镜治疗直径≤2 cm上尿路结石安全、有效。对于直径>2 cm肾结石的疗效有待进一步研究验证。

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abstracts:

Objective:To introduce the preliminary experience of domestic disposable digital flexible ureteroscope (ZebraScope?)in the treatment of upper urinary calculi.Methods:The clinical data of 16 patients with upper urinary calculi treated by ZebraScope? in our hospital from February to March 2020 were retrospectively analyzed. The scope is composed of a handle and shaft, the image can be transferred through the transmission line at the end of the handle. There were 10 males and 6 females. The mean age was 42.1 years (26-63 years). 12 cases of upper ureteral calculi and 4 cases of renal calculi included. Mean diameter was 1.3cm (0.8-2.1cm). Ureteral stents were preoperatively placed in 4 patients and no pre-stent were in 12 patients. Two patients had a history of endoscopic lithotripsy. The ureteral sheath was used in 4 patients with F12/14, 10 patients with F11/13, and 2 patients with F10/12. Eight patients were treated with a stone basket. Intra-operative lithotripsy was performed using 200um optical fiber combined with holmium laser, and 6Fr ureteral stent was routinely indwelling for 2-4 weeks. The operation time, postoperative complications, hospital-in time, stone clearance rate and other related parameters were summarized and analyzed.Results:Of the 16 patients, 14 succeed and 2 patients failed and secondary operation was applied due to poor ureteral condition. The mean operative time was 55.6 minutes (32-115 minutes). The average laser emission time was 25.2 minutes (10-65 minutes). There was no image degradation and scope damage during the operation. All the patients recovered well after the operation, and no postoperative complications such as fever and pain occurred. Two patients received external physical vibration lithecbole therapy. The average hospital-in time was 1.2 days (1-3 days). One month after the operation, the calculi clearance rate was 87.5% (14/16).Conclusion:Our preliminary study found that ZebraScope? could be safe and effective in the treatment of upper urinary calculi less than 2 cm. Futhter verification is required in larger renal stones.

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期刊: 《中华泌尿外科杂志》2020年41卷8期 609-612页 ISTICPKUCSCDCA
栏目名称: 临床研究
DOI: 10.3760/cma.j.cn112330-20200421-00316
发布时间: 2020-09-28
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