负压吸引技术在经尿道输尿管软镜碎石术中的应用

Application of negative pressure suction technique in flexible ureteroscopic lithotripsy

摘要

经尿道输尿管软镜碎石术（FURL）是临床处理上尿路结石的主要微创内镜手术之一，但仍存在结石清除率低、术中肾盂内压高、术后感染风险高等临床痛点。自负压吸引技术运用于FURL以来，其可通过术中主动吸出结石粉末及灌注液，显著提高了术中即刻结石清除率，有效降低肾盂内压、增加术野清晰度，进一步提高了手术效率和安全性。随着技术的不断进步，负压吸引技术已经由最开始的单纯负压吸引进展至“灌注-测压-负压”一体化的智能控压系统。现负压吸引技术虽已广泛应用于FURL手术中，但在设备设计及操作应用等方面仍有优化空间。本文结合国内外文献重点介绍负压吸引技术的临床应用现状、技术进展及操作经验。

Abstract

Flexible ureteroscopic lithotripsy (FURL) is one of the major minimally invasive endoscopic techniques in the management of upper urinary tract stones, but it has problems of low stone-free rate, high intraoperative intra-pelvic pressure, and high risk of postoperative infection. Since the negative pressure suction technique has been applied to FURL, it can actively suck out the stone powder and perfusion fluid during operation, thus significantly improving the immediate intraoperative stone removal rate, effectively reducing the intrarenal pelvic pressure, increasing the clarity of the operation field, and significantly improving the efficiency and safety of FURL. With the continuous progress of technology, the negative pressure suction technique has evolved from the initial simple negative pressure suction to the intelligent pressure control system integrating ‘perfusion-measurement-negative pressure'. Although this technique is now widely used in FURL, there is still optimizing space in terms of device design and operational application. This article will focus on the clinical application, technical progress and operational experience of the negative pressure suction technique in the light of domestic and international literature.

关键词

负压吸引技术 / 经尿道输尿管软镜碎石术 / 上尿路结石

Key words

negative pressure technique / flexible ureteroscopic lithotripsy / upper urinary track stones

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基金资助

广州市临床重大技术项目(2024CL-ZD04)