微创经皮肾输尿管镜碎石术治疗上尿路结石

Percutaneous nephrolithotripsy for the treatment of upper urinary tract stones

目的 :探讨经皮肾微造瘘输尿管镜碎石、取石术 (PCNL)治疗肾、输尿管上段结石的临床疗效。方法 :在B超引导下经皮肾穿刺造瘘 ,并将穿刺通道扩张至F16 18,从通道插入输尿管镜到结石处 ,用气压弹道碎石机将结石击碎 ,取出碎石片。结果 :2 6例患者 ,17例一期取净结石 ,4例 1周后二期取净结石 ,5例肾盏内有小块结石残留 ,经体外震波碎石或软性肾镜取石后治愈。结论 :经皮肾微造瘘碎石、取石术疗效好、创伤小 ,可作为治疗肾、输尿管上段复杂结石的重要疗法 。

Objective:To evaluate the curative effects of renal or upper ureteral stones by means of percutaneous nephrolithotripsy (PCNL). Methods:Percutaneous nephrostomy under ultrasonography was performed. The tracts were dilated to 16 or 18F. Through theses tracts, stones were broken into small pieces by pneumatic lithotriptor and then removed by ureteroscope. Results:In the 26 cases, the stones were cleared off at one section in 17 cases, two sections in 4 cases after one week and 5 cases were cured by ESWL or soft nephroscope after PCNL.Conclusion:PCNL is believed to be a minimal invasive and good effective method for the treatment of renal or upper ureteral stones. The result would be better if PCNL combined with ESWL.