经皮肾镜气压弹道碎石取石术治疗体会

EXPERIENCE OF PERCUTANEOUS NEPHROLITHOTOMY(PCNL) FOR THE TREATMENT OF URETERAL CALCULI

目的:观察经皮肾穿刺输尿管肾镜气压弹道碎石术在治疗上尿路结石中的疗效并总结治疗经验。方法:用经皮肾镜方法治疗肾、输尿管上段结石。结果:本组78例。75例患者碎石取石成功。其中双通道取石5例、2次手术13例、3次手术6例,行ESWL治疗残余结石11例,Ⅰ期造瘘,Ⅱ期手术4例,其中3例因出血、1例因肾积脓。中转开放手术3例。术中、术后输血2例,1例200ml,另1例500ml。结论:经皮肾镜是一种安全、创伤小、有效的方法。合理的通道选择,可以提高手术疗效,减少并发症。

Objective： To assess the efficacy and the safety of percutaneous nephrolithotomy （PCNL） for the treatment of proximal ureteral calculi. Methods ：78 cases of proximal ureteral calculi were treated by PCNL. Results： 78 cases of clinical data were retrospectively analyzed. 75 cases were successfully cured by PCNL Among them,5 with two accesses PCNL, 13 patients were two times PCNL and 6 were three times. 11 cases with residual stones were treated by ESWL; 4 cases underwent two stage PCNL, 1 case because bleed and 3 because pyonephrosis; 3 cases with opening treatment; 2 cases with transfusion, one blood loss volume was 200 ml, other was 500 ml. Conclusion： PCNL is effective and safe for proximal ureteral calculi. The procedure shows a high success rate and low rate of complications.