#输尿管软镜下钬激光切开内引流术在肾盂旁囊肿治疗中的应用.doc

输尿管软镜下钬激光切开内引流术在肾盂旁囊肿治疗中的应用章庆华 宋正尧 林谦 [摘要] 目的：观察经尿道输尿管软镜下钬激光切开内引流术治疗肾盂旁囊肿的安全性、疗效及可行性。方法：回顾性分析我院2014年5月至2015年3月诊断肾盂旁囊肿的8例患者临床资料。其中男性3例，女性5例。年龄32~74岁，平均年龄56岁，病程2~36个月，平均21个月。临床表现为间歇性肉眼血尿1例，反复腰痛3例，排尿刺激症状伴高血压2例，无症状但随访发现囊肿增大者2例。CTU提示肾盏受压迫变形2例，无肾积水表现两侧肾脏显影正常。8例均采用全麻下行输尿管软镜下钬激光切开内引流术，内切开囊壁直径约1.5~2.5cm，使之与集合系统相通，于囊肿内留置双J管引流。结果：8例手术均顺利完成，术中术后无大出血、感染性休克、漏尿等并发症，手术时间为28~43min，平均32min，术后住院时间为3~6天，平均4天，术后复查肾功能未及明显异常。术后随访3~12个月，囊肿均消失，无囊肿复发、感染、血肿形成等。结论：输尿管软镜下钬激光切开内引流是治疗肾盂旁囊肿的一种安全、有效的微创新术式，该术式具有创伤小、恢复快、疗效可靠、并发症少、治愈率高、术后住院日缩短等优点，可作为该类型囊肿的首选术式。 [关键词] 输尿管软镜；肾盂旁囊肿；内切开，引流 ZHANG Qing-hua SONG Zheng-yao LIN Qian （Department of UrologyTaizhou First People’s Hospital，Taizhou，China，318020；） Corresponding authorZHANG Qing-hua，E-mail @163.com Abstract Objective：To investigate the safety and efficiacy of incision and drainage by flexible ureterscope in the treatment of peripelvic renal cyst.Methods：The clinical data of 8 patients(3 male，5 female) with peripelvic renal cyst from May 2014 to Mar 2015 were retrospectively analyzed.The mean age was 56 years (range 32~74 ).The mean diameter of the cyst was 3.2 cm (range 1.2~5.6).All patients had undergone endo-dectortication by flexible ureterscope.A 1.5~2.5 cm incision was made at thin avascular area between cyst and pelvis by 200μm Holium laser to connect the cyst with the renal collecting system.The doubl-J stent was placed for drainage at the end of the procedure.Results：All operations were successfully performed，without conversion to open surgery or serious intraoperative complications.The mean opetation time was 32min (28~43min).Cysts disappeared in all patients during the follow-up of 3 months to 12 months..Conclusions：The endo-dectortication of peripelvic renal cyst by flexible uretescope with Holium laser is safe，effective and mini-invasibe，worthy of being used in clinic. Key words Flexible?ureteroscopy；Peripelvic renal cystic；Incision；Drainage 1材料与方法 1.1.1临床材料 回顾性分析2014年5月至2015年3月我院采用输尿管软镜治疗的8例肾盂旁囊肿的临床资料，其中男性3例，女性5例。年龄32