实时超声在输尿管软镜治疗飞行员肾微小结石中的临床价值

目的：探讨应用实时超声动态引导输尿管软镜治疗飞行员肾微小结石的临床价值。 方法：选择2014年10月—2021年10月民航在我院体检中超声或CT诊断肾微小结石（直径<5mm）的飞行员及飞行学员380例共计428枚结石，依患者意愿按治疗方式分为体外冲击波碎石组（ESWL）和输尿管软镜组，进行结石排出率及相关并发症的回顾性分析。 结果：体外冲击波碎石组（ESWL）组中178例患者178枚结石，术后排出结石78枚，排出率为43.8%，输尿管软镜组中202例患者250枚结石，除5枚肾盏憩室结石，在超声实时引导下排出245枚结石，排出率为100%。两组患者均无严重并发症，发生率比较差异无统计学意义。 结论：实时超声引导输尿管软镜取石术，对机体的损伤介于体外冲击波碎石（ESWL）与经皮肾镜取石(PNCL)之间，特别是在实时超声动态监测及引导下，具备高效精准、安全及恢复时间短等优势，术中可对肾盏憩室结石是否需要清除可应用超声造影剂进行手术指证评估，可作为飞行人员无症状性肾微小结石治疗的首选方式。

The clinical value of real-time ultrasound-guided flexible ureteroscope in the treatment of renal micro calculus in pilots

Abstract : Objective: to evaluate the clinical value of real-time ultrasound-guided flexible ureteroscope in the treatment of renal micro calculus in pilots. Methods: a total of 380 pilots who underwent physical examination in our hospital from October 2014 to October 2021 and were diagnosed with renal microlithiasis by ultrasound or CT were selected, and a total of 428 stones were found. According to the wishes of the patients, they were divided into extracorporeal shock wave lithotripsy group and ureteroscopy group, and the stone excretion rate and related complications were analyzed retrospectively. Results: in the extracorporeal shock wave lithotripsy group, there were 178 patients with 178 stones. 78 stones were excreted after operation, and the excretion rate was 43.8%. In the ureteroscopy group, there were 202 patients with a total of 250 stones. Except for 5 stones in the renal calyceal diverticulum, 245 stones were excreted, and the excretion rate was 100%. There were no serious complications in both groups, and there was no significant difference in the incidence of complications between the two groups. Conclusion: the damage to the body by real-time ultrasound-guided flexible ureteroscope is between extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. Especially under real-time ultrasound-guided, it has the advantages of high efficiency, accuracy, safety and short recovery time. It can be used to evaluate whether the stones in the renal calyceal diverticulum need to be discharged during the operation. It can be used as the first choice for the treatment of asymptomatic renal micro calculus in pilots.