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外科研究与新技术（中英文）

外科研究与新技术（中英文） ›› 2025, Vol. 14 ›› Issue (2): 174-176.doi: 10.3969/j.issn.2095-378X.2025.02.017

• 论著 • 上一篇    下一篇

输尿管软镜碎石术治疗上尿路结石的效果与安全性分析

曹海兵   

  1. 无锡市第二中医医院外科, 江苏 无锡 214000
  • 收稿日期:2024-04-25 出版日期:2025-06-28 发布日期:2025-07-07

Efficacy and safety of flexible ureteroscopy for upper urinary tract stones

CAO Haibing   

  1. Department of Surgery, Wuxi Second Hospital of Traditional Chinese Medicine, Wuxi 214000, Jiangsu, China
  • Received:2024-04-25 Online:2025-06-28 Published:2025-07-07

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摘要： 目的 探讨输尿管软镜碎石术（FURS）治疗上尿路结石的效果与安全性。方法 回顾性分析2022年4月—2023年12月60例上尿路结石患者的临床资料,均行FURS,其中肾盂结石13例,肾上盏结石11例,肾中盏结石14例,肾下盏结石10例,输尿管上段结石12例,结石直径≤20 mm有39例,20~40 mm有21例。结果 60例患者均顺利完成手术,手术时间（44.29±11.71）min,术中无并发症发生,术后发热11例（18.33%）,血尿14例（23.33%）,尿脓毒血症1例（1.67%）,腰痛5例（8.33%）。所有患者均获随访,53例患者达到清石标准,其中无结石残留39例,有≤4 mm结石残留14例,总的清石率为88.33%;7例未达到清石标准,未清除率为11.67%,其中4例选择行体外冲击波碎石,3例再次行软镜下碎石。肾盂、肾上盏、肾中盏、肾下盏、输尿管上段结石的一期清石率分别为100.00%（13/13）、81.82%（9/11）、100.00%（14/14）、60.00%（6/10）、91.67%（11/12）;结石直径≤20 mm、20~40 mm的一期结石清除率分别为92.31%（36/39）、80.95%（17/21）,不同部位、不同直径结石的一期清石率比较,差异无统计学意义（P>0.05）。随访8~19个月,无结石复发及肾萎缩发生。结论 FURS治疗上尿路结石,一期清石率高,总体安全、可靠。

关键词: 上尿路结石, 输尿管软镜碎石术, 安全性

Abstract: Objective To investigate the efficacy and safety of flexible ureteroscopy （FURS） in the treatment of upper urinary tract stones. Methods The clinical data of 60 patients with upper urinary tract stones from April 2022 to December 2023 were retrospectively analyzed. All patients were treated with FURS. Among them, there were 13 cases of renal pelvis stones, 11 cases of upper calyceal stones, 14 cases of middle calyceal stones, 10 cases of lower calyceal stones, 12 cases of upper ureter stones; 39 cases of stone diameter ≤20 mm, 21 cases of 20-40 mm stones. Results All the 60 patients successfully completed the operation, and the operation time was （44.29±11.71） min. No complications occurred during the operation. After operation, 11 cases of fever （18.33%）, 14 cases of hematuria （23.33%）, 1 case of urinary sepsis （1.67%）, 5 cases of lumbago （8.33%） occurred. All patients were followed up, and 53 patients reached the stone removal standard, among which 39 patients had no stone residue and 14 patients had stone residue ≤4 mm, and the total stone removal rate was 88.33%; 7 cases did not meet the standard of stone removal, and the unremoved rate was 11.67%, among which 4 cases received extracorporeal shock wave lithotripsy, 3 cases again underwent FURS.The first-stage removal rates of renal pelvis, upper calyceal, middle calyceal, lower calyceal, and upper ureter stones were 100.00%（13/13）, 81.82%（9/11）, 100.00%（14/14）, 60.00%（6/10）, and 91.67%（11/12）, respectively. The first-stage removal rates of stones with diameter ≤20 mm and 20-40 mm were 92.31% （36/39） and 80.95% （17/21）, respectively. There were no statistically significant differences in the first-stage removal rates of stones in different parts and with different diameters （P>0.05）. The patients were followed up for 8 to 19 months, and no stone recurrence or renal atrophy occurred. Conclusion FURS is safe and reliable in the treatment of upper urinary tract stones with high first-stage stone removal rate.

Key words: Upper urinary tract stone, Flexible ureteroscopy, Safety

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