经皮肾镜取石术并同期冷刀内切开治疗UPJO的疗效观察  

Treatment outcomes of percutaneous nephrolithotomy and simultaneous cold-knife endopyelotomy for UPJO

作　　者：兰东阳[1] 庞自力[1] 章小平[1] 潘峰[1] 鞠文[1] 范民[1] 管富勇 于营[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院泌尿外科,武汉430022

出　　处：《临床泌尿外科杂志》2015年第5期429-432,共4页Journal of Clinical Urology

摘　　要：目的：观察经皮肾镜取石术并同期冷刀内切开治疗肾盂输尿管连接部梗阻（UPJO）患者的疗效。方法：2011年3月～2014年10月采用经皮肾镜取石术并同期冷刀内切开治疗UPJO患者19例，并观察其手术时间、术后并发症、住院时间、术后患者腰痛等临床症状是否缓解及肾积水是否消失等情况。结果：19例患者平均手术时间96（50～145）min，术后平均住院时间8．4（5～11）d；围手术期并发症4例（21．1％），术后双J管相关并发症2例（10．5％）。随访1～43个月，平均12个月，手术成功率84．2％（16／19）。3例手术失败者行二次开放手术干预，其中2例发现异位血管存在，1例术中发现周围瘢痕粘连严重。结论：经皮肾镜取石术并同期冷刀内切开治疗UPJO合并肾结石患者是一种安全、可靠、有效的治疗方法，可作为首选的手术方式。Objective：To evaluate the clinical treatment outcomes of percutaneous nephrolithotomy and simul- taneous cold-knife endopyelotomy for ureteropelvic iunction obstruction （UPJO）. Method：From March 2011 to Oc- tober 2014, 19 patients in our institution had been performed percutaneous nephrolithotomy and simultaneous cold- knife endopyelotomy. We retrospectively analyzed the clinical data including operation time, postoperative compli- cations, hospital stay, postoperative back pain and the improvement of hydronephrosis. Result：The mean operation time was 96 （range, 50-145） rains, and mean postoperative hospital stay was 8. 4 （range, 5-11） days. The inci- dence of perioperative complication was 21.1% （4/19）, and the incidence of double-J stent related complications rate was 10.5% （2/19）. Over a mean follow-up period of 12 （range, 1-43） months the operation success rate was 84.2% （16/19）. Recurrence of UPJO was observed in three cases. Significant crossing vessels were encountered at open pyeloplasty in two of three patients, and serious cicatricial adhesion was found in the third patient. Conclu- sion：Percutaneous nephrolithotomy and simultaneous cold-knife endopyelotomy for UPJO is safe, reliable and ef- fective for patients with UPJO combined with kidney stones and can be considered as the first choice of invasive therapy.

关 键 词：肾盂输尿管连接部梗阻 肾结石 经皮肾镜取石术 冷刀内切开术 

分 类 号：R692[医药卫生—泌尿科学]