42例输尿管上段结石的经皮肾造瘘输尿管镜碎石治疗

42 Cases of Upper Ureteral Calculi of the Treatment with Percutaneous Nephrostolithotomy

目的:探讨经皮肾造瘘输尿管镜碎石术(PCNL)治疗输尿管上段结石的方法和疗效。方法:PCNL治疗42例输尿管上段结石,对其方法和疗效进行分析。结果:38例I期PCNL,残石率15.78%(6/38)。2例I期经皮肾造瘘(PCN),Ⅱ期PCNL。2例因术中Peel-away鞘连同安全导丝一并脱出,改开放手术。结论:PCNL治疗输尿管上段结石具有创伤小、安全、操作相对简单、残石率低、出血少、恢复快、并发症少的优点。

Objective To discuss the methods and effect of upper ureteral calculi of the treatment with percutaneous nephrostolithotomy（PCNL） Methods To review 42 cases of upper ureteral calculi of the treatment with percutaneous nephrostolithotomy, and to discuss the methods and effect of PCNL. Results 38 cases received the first phase- PCNL, 32 cases of them hadn＇t renal residual stone ,6 cases had renal small residual stone （5 cases of coexisting renal calculi and 1 case of simple ureteral calculi）, renal residual stone rate was 15.78% （6/38）.2 cases received the first phase of percutaneous nephrostomy （PCN） and the second phase of PCNL because of vague operative view induced by bleeding and congealed blood in 1 case and coexisting pyogenic kidney in 1 case. 2 cases received open-operation because of Peel-away sheath and guide wire breaking away from renal pelvis. All hadn＇t blood transgusion and complication. Conclusion Upper ureteral calculi of the treatlment with PCNL is mini-injury, sale, easy, low residual stone rate, little bleeding, rapid recovering, and few complications.