两种途径输尿管镜技术联合治疗肾-输尿管结石

Combinned transurethral and percutaneous ureteroscopic technique to treat complex renal-urethral calculi

目的探讨经尿道输尿管镜和经皮输尿管镜联合治疗复杂肾输尿管结石的疗效和安全性。方法对30例复杂肾输尿管结石患者采用了经尿道输尿管镜和经皮输尿管镜联合碎石的治疗方法,其中经尿道输尿管镜配合钬激光碎石,经皮输尿管镜配合气压弹道碎石。结果35例输尿管结石一次碎石成功率为94.29%(33/35),36例肾结石一次碎石成功率为83.33%(30/36)。全部患者未出现明显的大出血、假道、穿孔、尿路感染等并发症。结论联合采用经尿道输尿管镜和经皮输尿管镜治疗复杂肾输尿管结石具有损伤小、手术安全、取石方便、残石率低等优点,值得进一步推广。

Objective To discuss the effectiveness and safety of combined trans-urethral ureteroscopy and percutaneous nephrostomy method for the treatment of complex renal-ureteral calculi.Methods We treated 30 patients with complex renal-ureteral calculi by combined trans-urethral ureteroscopy and percutaneous nephrostomy method.Holmium-YAG laser lithotripsy was used in the trans-urethral ureteroscopic method,and pneumatic lithotripsy was used in the percutaneous nephrostomy method.Results The one-session success rate of lithotripsy in 30 cases(35 sides) of urethral stones was 94.29%,and the one-session success rate of lithotripsy in 30 cases(36 sides) of renal stones was 83.33%.No obvious massive hemorrhage,false passage,perforation et al,occurred in all patients.Conclusion Combined trans-urethral ureteroscopy and percutaneous nephrostomy method for the treatment of complex renal-ureteral calculi has the advantage of microinvasiveness,safety,and high success rate.It's worth popularizing.