两步法经尿道输尿管软镜精准治疗肾盂旁囊肿的临床疗效观察

摘要： 目的 观察两步法经尿道逆行输尿管软镜精准治疗肾盂旁囊肿的临床效果。方法 2014 年5 月-2015 年11 月，于该院住院的肾囊肿患者中，23 例接受两步法经尿道输尿管软镜逆行肾盂旁囊肿内引流 术，回顾性分析该组患者临床资料，观察治疗效果。结果 所有患者均I 期手术成功，其中4 例患者穿刺抽液 证实为肾盏憩室，行输尿管软镜憩室口扩大引流术，其余19 例均证实为肾盂旁囊肿，行囊壁内切开内引流成 功，手术前后血红蛋白下降率无明显变化。无需输血，术后平均住院时间2 d，术后第1 天复查尿路平片观察 DJ 管位置，术后1 个月复查超声或CT，囊肿体积均明显缩小，术后随访6 个月至1 年，所有患者均无远期并 发症。结论 两步法经尿道输尿管软镜精准治疗能够精准鉴别肾盂旁囊肿和肾盏憩室，为下一步手术明确方 向，手术操作简单，无明显并发症，术后恢复快，是治疗肾盂旁囊肿的理想治疗方法。
Abstract: Objective To observe ransurethral flexible ureteroscopey for two-step precise method treatment of parapelvic cyst. Methods From May 2014 to November 2015, 23 patients of parapelvic cyst underwent a ransurethral flexible ureteroscopey for two-step precise method treatment, then analyze the clinical data of patients, observe the therapeutic effect. Results All patients underwent primary surgery successfully while 4 cases among them were confirmed as urine level puncture calyceal diverticulum treated with flexible ureteroscopy diverticulum expand drainage, the other 19 cases were confirmed as renal cyst and treated with cyst incision drainage successfully. The hemoglobin before and after surgery showed no changes. With no blood transfusion, the average postoperative hospitalization time was 2 d. 1 day after surgery, KUB was to locate the DJ tube position; 1 month later, ultrasound or CT check show that the cyst volume was significantly reduced, postoperative follow-up range from 6 months to 1 year. All the patients had no long-term complications. Conclusion Ransurethral flexible ureteroscopey for two-step precise method treatment of parapelvic cyst and renal pelvis lamp beside diverticulum provide a clear direction for the next operation. It’s simple operation with no significant complications and recovered quickly, which is an ideal method for the treatment of renal pelvic.