微创腔镜技术治疗结石性脓肾46例疗效分析

Treatment of calculous pyonephrosis with minimally invasive endoscopic technique

目的探讨用微创腔镜技术治疗结石性脓肾的疗效。方法结石性脓肾患者46例,其中32例采用微创经皮肾镜取石术,11例采用经尿道输尿管镜取石术,3例同时采用微创经皮肾镜取石和经尿道输尿管镜取石术治疗。结果术后40例获得随访6个月～5年,患肾功能恢复或部分恢复31例(77.5%),患肾萎缩(无功能)7例(17.5%),患肾切除2例(5%)。结论腔镜技术治疗结石性脓肾是安全、有效的;早期诊断、及时引流、解除梗阻是结石性脓肾保肾治疗的关键。

Objective To investigate the feasibility of treatment of calculous pyonephrosis with minimally endoscopic technique. Methods 46 cases of calculous pyonephrosis were treated by endoscopic technique （32 by mini-percutancous nephrolithotomy, 11 by transurethral ureteroscopy,3 by mini-percutancous nephrolithotomy and transurethral ureteroscopy together）. Results 40 cases have been followed up for 6 months to 5 years. The renal function improved in 77.5%（31/40）. Renal atrophy was observed in 17.5% （7/40） and nephrectomy in 5% （2/40）. Conclusion It is safe and effective to treat calculous pyonephrosis with endoscopic technique.The key to the treatment of calculous pyonephrosis by kidney-sparing operation is early diagnosis ,timely drainage and relief of obstruction.