经皮肾镜治疗嵌顿性输尿管上段结石(附81例报告)  

Clinical efficacy of combined pneumatic and ultrasound lithotripsy under percutaneous nephrolithotomy for incarcerated proximal impacted ureteral stone (reports of 81 cases)

作　　者：奉友刚[1] 高振利[1] 石磊[1] 刘庆祚[1] 王建明[1] 姜仁慧[1] 

机构地区：[1]青岛大学附属烟台毓璜顶医院泌尿外科,264000

出　　处：《临床外科杂志》2008年第10期700-701,共2页Journal of Clinical Surgery

摘　　要：目的评价经皮肾镜下气压弹道联合超声碎石术处理嵌顿的输尿管上段结石的疗效。方法回顾性分析2005年6月至2008年4月采用经皮肾镜下气压弹道联合超声碎石术治疗嵌顿的输尿管上段结石81例临床资料。结果81例患者均成功建立皮肾通道,均一期单通道碎石,手术时间35～120min,结石完全清除率98.7%(80/81)。1例患者结石残留,经ESWL治疗;11例术后出现发热,给予适当的抗生素及支持性治疗;4例患者因术中出血输浓缩红细胞2U;均获治愈。随访1～9个月,无严重手术并发症。结论经皮肾镜下气压弹道联合超声碎石术用于处理嵌顿的输尿管上段结石是安全有效的方案。Objective To evaluate the clinical efficacy of impacted proximal ureteral stone treated by combined pneumatic and ultrasound lithotripsy under percutaneous nephrolithotomy （PCNL）. Methods From June 2005 to April 2008, 81 cases of incarcerated proximal ureteral stone underwent combined pneumatic and ultrasonic lithotripsy under PCNL. Results All the percutaneous renal tunnel was successfully established, of which 1 tunnel was used in 81 cases. All of them underwent one stage lithotripsy. Operation time ranged from 45 to 120 min. Stones were cleared in 80 out of 81 cases （98. 7% ）. One case of residual stones was cured by adjuvant extracorporeal shock wave lithotripsy （EWSL）. Four cases experienced transient postoperative fever that could be controlled with appropriate antibiotics and supportive treatment. Two U of concentrated red blood ceils were transfused in 4 cases because of pefioperative bleeding. No complication occurred during a follow - up period of 1 to 9 months. Conclusion Percutaneous nephroscopic ureterolithotripsy is a safe and efficient treatment option for the removal of incarcerated proximal ureteral stones.

关 键 词：输尿管结石 肾造口术 碎石术 

分 类 号：R699[医药卫生—泌尿科学]