摘要
目的 探讨输尿管软镜术后输尿管石街并结石粉末堵塞输尿管支架管致管周与管内引流不畅的临床表现及诊治方法.方法 回顾性分析2022年6月遵义医科大学附属医院泌尿外科收治的1例输尿管软镜术后输尿管石街并结石粉末堵塞输尿管支架管患者的输尿管软镜术后输尿管石街并结石粉末堵塞输尿管支架管病例,并复习相关文献.结果 患者以反复恶心呕吐为主要症状伴左下腹部疼痛不适,予止吐、排石、解痉等保守治疗后症状持续不缓解,经输尿管镜检查行钳夹取石及更换输尿管支架管后,呕吐及疼痛症状消失.结论 当输尿管软镜术后早期出现输尿管梗阻相关症状,如剧烈恶心及呕吐、输尿管走行区疼痛不适等,同时影像学发现输尿管石街、输尿管及肾盂扩张积水时,需考虑到输尿管石街及结石粉末堵塞输尿管支架管致管周与管内引流不畅,应及时手术清除石街,更换新的输尿管支架管,改善患者症状.
Abstract
Objective To investigate the clinical manifestations and diagnosis and treatment of ureteral stone street with stone powder occlusion of ureteral stent tubes leading to peritubular and intratubular drainage malfunc-tion after ureteral flexible ureteroscopy.Methods Retrospective analysis of a case of ureteral stone street with stone powder occlusion of ureteral stent tube after ureteroscopy admitted to the Department of Urology of the Affil-iated Hospital of Zunyi Medical University in June,2022,combined withreview of the relevant literature.Re-sults The patient had recurrent nausea and vomiting as the main symptom with pain and discomfort in the left lower abdomen.After conservative treatment with antiemetic,lithotripsy and antispasmodic therapy,the symp-toms persisted unrelieved,and after ureteroscopy with forceps removal of the stone and replacement of the ureter-al stent tube,the symptoms of vomiting and pain disappeared.Conclusion When symptoms related to ureteral ob-struction,such as severe nausea and vomiting,pain and discomfort in the ureteral tract,etc.,appear in the ear-ly period after flexible ureteroscopy,and at the same time the imaging findings indicate ureteral stone street,di-lated hydronephrosis of ureter and renal pelvis,it is necessary to take into account that ureteral stone street and powdered stone block the ureteral stent tube,resulting in peritubular and intraluminal drainage,and it is neces-sary to timely surgically remove the stone street,and replace with new ureteral stent tubes,so as to improve the patient's symptoms.
国家科技期刊平台
NSTL
万方数据