输尿管上段结石并中、重度肾积水的经皮肾镜碎石术治疗  

Percutaneous nephrolithotomy for the treatment of upper ureteral calculi with moderate or severe hydronephrosis

作　　者：梁辉[1] 陈炜[1] 涂响安[1] 邓立文[1] 赵良运[1] 赵亮[1] 曾令友[1] 王文卫[1] 

机构地区：[1]中山大学附属第一医院黄埔院区泌尿外科,广州510070

出　　处：《中华腔镜泌尿外科杂志（电子版）》2010年第6期38-40,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨超声引导下经皮肾镜碎石术治疗输尿管上段结石并中、重度肾积水的临床疗效。方法输尿管上段结石并中、重度肾积水患者239例,男136例,女103例。年龄22～75岁,平均45岁。左侧106例,右侧133例,合并患侧结石56例。均采用超声引导下经皮肾镜气压弹道碎石或钬激光碎石治疗。术后留置双J管2～6周。结果 239例均一期碎石成功。平均手术时间40min,术后平均住院时间5d,结石清除率为100%。术中无气胸、腹腔脏器损伤等严重并发症发生;术后大出血1例。结论超声引导下经皮肾镜碎石术治疗输尿管上段结石效率高、并发症少,是治疗复杂性输尿管上段结石并中、重度肾积水的安全、有效方法。Objective To evaluate the clinical efficacy of percutaneous nephrolithotomy（PCNL） for the treatment of upper ureteral calculi with moderate or severe hydronephrosis.Methods We retrospectively investigated 239 cases（136 males,103 females） who underwent PCNL using pneumatic lithotripsy or holmium laser lithotripsy for upper ureteral calculi with moderate or severe hydronephrosis.The mean age was 45 years（range from 22 to 75 years）.The stone located in the left side in 106 cases and 133 cases in the right side.56 of them accompanied with kidney calculi.Results The percutaneous access was established successfully under Btype ultrasound guidance and immediate phase one lithotripsy was performed in all patients.Average operation time was 40 minutes and average hospitalization duration was 5 days after operation.No severe complications such as pneumatothorax and organ injury occurred during the operation.Stone free rate was 100%.One case suffered from massive hemorrhage after the surgery.Conclusion PCNL with pneumatic or holmium laser and ultrasonic power under B-type ultrasound guidance is efficient and causes less complication,it is suitable for the treatment of upper ureteral calculi with moderate or severe hydronephrosis.

关 键 词：输尿管结石 肾积水 经皮肾镜碎石术 

分 类 号：R699[医药卫生—泌尿科学]