Kết quả điều trị sỏi thận bằng tán sỏi laser qua nội soi ống mềm ngược dòng có sử dụng ống nòng niệu quản hai kênh hút liên tục tại bệnh viện Đa khoa Quốc tế Hải Phòng=Outcome of renal stone treatment by retrograde intrarenal surgery using two channel sheath with continuing aspiration at Hai Phong International hospital

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Minh Đức Phạm, Việt Hà Phạm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.43-48

Bộ sưu tập: Metadata

ID: 242616

Thêm vào giỏ

Đánh giá kết quả điều trị của tán sỏi nội soi bằng ống soi mềm trong điều trị sỏi thận có sử dụng ống nòng niệu quản hai kênh hút liên tục và xem xét lại các nghiên cứu mới nhất trong y văn về tán sỏi thận bằng ống soi mềm. Đối tượng và phương pháp: Mô tả tiến cứu từ tháng 4/2023 đến tháng 10/2023. Kết quả: 91 bệnh nhân, tuổi trung bình là 50,76 ± 13,25, tỷ lệ nam và nữ lần lượt là 61,5% và 38,5%. Kích thước trung bình của sỏi là 18,59 ± 10,21 mm. Sỏi bể thận và sỏi đài thận dưới đơn thuần chiếm nhiều lần lượt 26% và 25%. Đặt JJ trước mổ chiếm tỷ lệ 97,8% số bệnh nhân. Có 3 cỡ ống nòng niệu quản hai kênh được sử dụng là 11Fr, 12Fr và 13Fr với tỷ lệ lần lượt là 86,8%, 12,1% và 1,1%. Đa số đưa được ống nòng niệu quản vào đến bể thận chiếm tỷ lệ 83,5%. Nước vào ra qua kênh nước tốt chiếm 93,4% và ống nòng niệu quản được cố định tốt chiếm 62,6%. Thời gian phẫu thuật trung bình là 63,01±35,56 phút. Tỷ lệ sạch sỏi ngay sau phẫu thuật và sau 03 tháng lần lượt là 92,3% và 73,6%. Tai biến trong mổ bao gồm chảy máu chiếm 4,4%, tổn thương niệu quản 7,7%. Các biến chứng sau mổ bao gồm tụ máu quanh thận 2,2% và nhiễm trùng tiết niệu 4,4%. Kết luận: Tán sỏi thận bằng ống soi mềm có sử dụng nòng niệu quản hai kênh hút liên tục là một phương pháp an toàn, có thể cho phép tán sỏi lâu, sỏi có kích thước lớn và có tỷ lệ sạch sỏi cao, tỷ lệ biến chứng sớm thấp.The aim of this study is to evaluate the result of RIRS with two-channel sheath and continuing aspiration and review some literature on this field. This is prospective study which is conducted in Haiphong international hospital from 4/2023 to 10/2023. The study included 91 patients with mean age 50.76 ± 13.25 years, 56 (61.5%) were males, 35 (38.5) were females. Mean size of the stone was 18.59 ± 10.21 mm. The stones were 26% found in renal pelvis and 25% in lower pole. Stent JJ was placed before RIRS in 89 (97.8%) patients. There were 3 kinds of size of twochannel ureteral sheath 11Fr, 12Fr, 13Fr with the percentage was 86.8%, 12.1% and 1.1% respectively. Infundibular length inferior to 30mm was 73.6%, infundibular width superior to 5mm was 87.9%. The percentage of lower pole infundibulopelvic angle superior to 450 was 48.4%. Winding ureter which prevented sheath to the pelvis was about 90.2%. The good aspiration was 93.4% and the good fixation of ureteral sheath was 62.6%. The mean operation time was 63.01±35.56 minutes. Stone clearance right after RIRS and after 1 months were respectively 92.3% and 73.6%. Hemorrhage during operation was 4.4% and ureteral wound was 7.7%. Subcapsular renal hematoma formation was found in 2 (2.2%) and urinary tract infection was 4.4% after RIRS. RIRS using two-channel sheath with continuing aspiration is safe and efficient technique for treating kidney stones with high rate of stone clearance, low complications and can be applied to stone in big size.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR