微创经皮肾取石术治疗ESWL不成功输尿管上段结石(附36例报告)

Minimally Invasive Percutaneous Nephrolithotomy Treat Upper Ureteric Calculi Failed to ESWL(Report of 36 Cases)

目的:探讨应用微创经皮肾穿刺取石术(MPCNL)治疗ESWL不成功输尿管上段结石的疗效。方法:2004年10月～2007年12月,收治ESWL不成功输尿管上段结石患者36例。其中肉芽组织包裹结石18例,结石部位息肉形成12例,结石远端输尿管炎性狭窄6例。36例患者均采用微创经皮肾穿刺取石术进行治疗,取石的同时处理输尿管息肉和炎性狭窄。结果:36例患者行MPCNL的一次性结石清除率为100%,无大出血、胸膜损伤、尿瘘等并发症发生,平均住院时间8.7天(7～10天)。结论:MPCNL治疗输尿管上段结石损伤小、并发症少,结石取尽率高并且可以同时治疗输尿管病变,是ESWL不成功输尿管上段结石的有效微创治疗方法。

Objective：To study the efficacy of minimally invasive percutaneous nephrolithotomy（MPCNI.） for upper ureteric calculi failed to extracorporeal shock wave lithotripsy （ESWL）. Methods： 36 cases of upper ureteric calculi failure to ESWI. were treated with MPCNL from Oct. 2004 to Dec. 2007. Among them, 18 cases with granulation tissue and 12 cases with polypus at the site of calculi, 6 cases with inflammatory stenosis of ureter at the distant site of calculi. All the cases were received MPf＇NL on the disease of ureter such as polypus or inflammatory stenosis. Results：The stone free rate was 100% in 36 cases. There were no severe surgical complications such as hemorrhage, pleural damage and urinary leakage. The average hospital stay was 8.7 d （7-10 d）. Conclusions： MPCNL has the characteristics of slight injury and less complication. It has high successful rate in the treatment of upper ureteral stones and may treat the disease of ureter at the same time. It is a safe, effective and mini mally invasive intervention for treatment of upper ureteric calculi failed to ESWL.