输尿管结石致肾积脓的输尿管镜钬激光治疗

Transureteroscopic Holium Laser Lithotripsy Treatment of Calculus Obstructive Pyonephrosis

目的总结输尿管镜钬激光碎石治疗输尿管结石致肾积脓的经验。方法13例患者因腰痛、发热入院，明确诊断，术前给予抗感染及支持治疗，手术采用输尿管镜钬激光碎石术。结果10例顺利完成手术，3例输尿管上段结石在碎石过程中有结石上移，放置双J管后行体外冲击波碎石治疗。无并发症发生，恢复良好。结论输尿管镜钬激光碎石治疗结石梗阻性肾积脓具有疗效好、损伤小、手术时间短、安全可靠等优点，可作为输尿管结石致梗阻性’肾积脓首选治疗方法。

Objective To summarize the experiences of treatment of calculus obstructive pyonephrosis with transureteroscopic holium laser lithotripsy. Methods There were 13 patients with flank pain and fever, all patients received antibacterial therapy and nutritional support before operation, the patients of calculus obstructive pyonephrosis were treated using transureteroscopic holium laser lithotripsy. Results The ureteral calculus were cleared off in 10 cases,and in three cases,the stone moved to pelvis during operation that they needed additional procedure of ESWL, no severe complications were observed. Conclusion Transureteroscopic holium laser lithotripsy is safe,minimal invasive and effective method for treatment of calculus obstructive pyonephrosis and the therapeutic scheme can be the first choice.