经皮肾镜内切开术联合碎石术治疗UPJO并肾结石25例报告  

Percutaneous endopyelotomy for ureteropelvic junction obstruction associated with renal calculi

作　　者：康绍叁[1,2] 高伟兴[2] 张立国[2] 刘健[2] 曹凤宏[2] 李晓强[2] 张志宏[1] 徐勇[1] 

机构地区：[1]天津医科大学第二医院泌尿外科,天津300211 [2]河北联合大学附属医院泌尿外科

出　　处：《临床泌尿外科杂志》2012年第3期174-176,共3页Journal of Clinical Urology

摘　　要：目的:观察经皮肾镜内切开术联合碎石取石术治疗UPJO并肾结石的可行性、疗效及临床应用价值。方法:对25例UPJO并肾结石的患者采用经皮肾镜肾盂内切开术加碎石取石术进行治疗。结果:平均手术时间80min,术中出血量100～500ml,平均住院11.2d。23例患者一次完成手术,2例行Ⅱ期手术处理残石。其中单通道治疗19例,双通道治疗6例,清石率为88%。无大出血等严重并发症发生。随访6个月～3年,UPJO有效率为92%,2例患者术后出现再狭窄,两次内切开无效后改为开放性离断肾盂成形术。结论:经皮肾镜肾盂内切开术联合碎石取石术创伤小,恢复快,疗效确切,是一种治疗UPJO并肾结石的有效方法。Objective.. We report our experience with percutaneous endopyelotomy at the time of percutaneous nephrolithotomy for treatment of UPJO with coexistent stone disease. Methods： We reviewed data on 25 patients underwent percutaneous endopyelotomy at the time of percutaneous nephrolithotomy at our institution. Results; Mean operative time was 80 minutes, blood lose was 100-500 ml, mean hospital stay was 11.2 days, 23 cases were completed in one stage, and 2 cases were perfomed two stages. Stone clearance was possible in 22/25 patients （88%）, no complication of serious blooding occurred, the improved drainage was 92% （23/25） at 6 mouths follow-up. 2 patients were transferred to Open pyeloplasty because of two times failure of endopyelotomy. Conclusions： Percutaneous endopyelotomy with percutaneous nephrolithotomy is feasible and effective procedure for UPJO associated with renal calculi with minimal incision and short recovery time.

关 键 词：肾结石 肾盂输尿管连接部狭窄 经皮肾镜碎石取石术 肾盂内切开术 

分 类 号：R692.4[医药卫生—泌尿科学] R693[医药卫生—外科学]