腔内手术治疗双输尿管畸形合并上尿路结石  

Endoscopic Operation for Duplication of Ureter Combined with Upper Urinary Calculi

作　　者：李宗武[1] 张士宝[1] 刘双庆[1] 周蕾[1] 郭峰[1] 张龙洋[1] 

机构地区：[1]山东大学附属济南市中心医院泌尿外科,山东济南250013

出　　处：《中国现代手术学杂志》2015年第5期391-393,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨双输尿管畸形合并上尿路结石腔内手术治疗的临床效果。方法回顾性分析2006年3月-2014年10月我科确诊并治疗的37例双输尿管畸形合并上尿路结石患者的临床资料,其中完全重复输尿管14例,不完全重复输尿管23例。合并肾结石7例,输尿管结石30例。本组37例患者均行腔内碎石术,其中15例行经皮肾微造瘘碎石术,22例行输尿管镜下碎石术。结果本组行输尿管镜下碎石术的22例中,20例碎石成功,2例因输尿管狭窄,其中1例应用6.3/7.5F输尿管镜碎石成功,1例改行经皮肾微造瘘碎石术取净结石。行经皮肾微造瘘碎石术的15例患者,除2例术后复查有残石（〈0.7 cm）外,其余患者均清除结石。所有患者无输尿管穿孔、撕脱、断裂、大出血、胸膜及肠道损伤发生。结论对于双输尿管畸形合并上尿路结石患者,腔内手术安全、有效。Objective To investigate the clinical effect of endoscopic operation of duplication of ureter combined with upper urinary tract calculi. Methods The clinical data of 37 patients with duplication of ureter combined with upper urinary tract calculi admitted from March 2006 to October 2014 were analyzed retrospectively,including 14 cases of complete ureteral duplication and 23 cases of incomplete ureteral duplication.7 cases were combined with kidney calculi,and 30 cases were combined with urinary calculi. All 37 cases were performed endoscopic lithotripsy,including 15 of minimally invasive percutanous nephrostomy and 22 of ureteroscopic lithotripsy. Results Out of 22 cases treated by ureteroscopic lithotripsy,20 cases obtained stone free,2 cases was failed due to ureterostenosis and conversed to MPCNL or ureteroscopy by 6. 3 /7. 5F ureteroscope. In 15 cases performed MPCNL,13 cases achieved stone free and 2 cases were found residual stones. No serious complications such as perforation,avulsion and rupture of ureter,hemorrhea,pleura injury and intestinal injury were found. Conclusion The endoscopic surgery of urology is safe and effective for treatment of the patients with ureteral duplication and upper urinary tract calculi.

关 键 词：泌尿生殖系统畸形 重复输尿管 尿路结石 碎石术 输尿管镜检查 肾造口术 经皮 

分 类 号：R699[医药卫生—泌尿科学]