PCNL治疗上尿路结石留置单J管的临床价值  

Percutaneous nephrolithotomy with single-J stent in treatment of upper urinary tract calculus

作　　者：张爱建[1] 萧芝松[1] 冯波[1] 杨银桂[1] 肖玉坤[1] 郑宝寿[1] 杨立[1] 文贵成[1] 

机构地区：[1]大理学院附属医院泌尿外科,云南大理671000

出　　处：《西部医学》2015年第1期83-84,共2页Medical Journal of West China

摘　　要：目的 探讨经皮肾镜碎石取石术（percutaneous nephrolithotomy,PCNL）治疗上尿路结石（upper urinary tract calculus,UUTC）术后留置单J管取代双J管及肾造瘘管的安全性及有效性.方法 分析19例UUTC患者的临床资料,观察PCNL术后留置单J管取代双J管及肾造瘘的安全性和有效性.结果 19例IUUTC患者中14例术后（74.0％）结石清除干净,4例（21.0％）残留无意义结石（结石直径＜0.4cm）,1例（5.0％）结石残留术后行体外冲击波碎石,排出结石.术后保持单J管引流通畅,均未出现重症感染、漏尿、大出血等严重并发症,术后3～4天均拔出单J管出院.随访1～3个月,无漏尿或迟发性出血病例.结论 对于体积小的上尿路结石,PCNL术后留置单J管作为输尿管支架管是安全有效的.Objective To evaluate the feasibility and clinic safety of replacing Double-J stent and nephrostomy tube with a single-J stent in percutaneous nephrolithotomy （PCNL） treated upper urinary tract calculus（UUTC）. Methods A retrospective study was done in 19 patients underwent PCNL for UUTC. The average amount of stones were 1-3 and the average diameter of stones about 2.4cm （ 1.6cm to 3.2cm）. All cases had hydronephrosis. We replaced Double-J stent and nephrostomy tube with a single-J stent in percutaneous nephrolithotomy （PCNL）. Results There were 14 cases （74%） with completed stone clearance, 4 cases （21%） with no clinical significance stones （calculi diameter 〈~0.4cm） and 1 patient （5%） with residual stone. All were dislodged single-J stent after 3 to 4 days without infection or other complications. During 1 to 3 months follow-up, no hydronepherosis, calculus or ureteral obstruction was shown in all pa- tients by urtrasonography or KUB＋IVP. Conclusion For the small size of upper urinary tract calculi, replacing Double- J stent and nephrostomy tube with a single-J stent in percutaneous nephrolithotomy （PCNL） are technically feasible and viable option.

关 键 词：上尿路结石 经皮肾镜碎石取石术 单J管 

分 类 号：R691.4[医药卫生—泌尿科学]