36例上尿路结石梗阻性脓肾的腔内治疗

Endourological Technique For Upper Urinary Tract Calculous Pyonephrosis

目的:探讨运用腔内泌尿外科技术治疗上尿路结石梗阻性脓肾的疗效。方法:对36例上尿路结石性脓肾患者行腔内治疗(8例Ⅰ期行经尿道输尿管镜取石术;28例Ⅰ期先行微创经皮肾造瘘引流术,Ⅱ期行经皮肾镜取石术和/或经尿道输尿管镜取石术)。对所有患者的临床资料进行分析回顾。结果:所有患者术后腰痛、发热及尿频尿急等症状均基本改善,无近远期严重并发症出现。术后随访3～18月,1例因反复肾盂肾炎最后行患肾切除,2例患肾明显萎缩,7例患肾轻微萎缩。结论:采用腔内泌尿外科技术治疗结石性脓肾是可行有效的,可作为首选。

Objective： To investigate the effect of the treatment of upper urinary tract calculous pyonephrosis with endourological technique.Methods： 36 cases of upper urinary tract calculous pyonephrosis were treated by endourological technique（8 cases were treated by one-stage transurethral ureteroscopy,28 cases by one-stage mini-percutaneous nephrostomy and second stage percutaneous nephrolithotomy or transurethral ureteroscopy）.Then the clinical datas were analyzed retrospectively.Results： The symptoms of lumbar pain and fever were improved after operation and hadn＇t severe early and long-term complications in all the patients.In Following up for three to eighteen months,one case was done the nephrectomy for repeat nephropyelitis,2 cases had renal atrophy obviously and 7 cases had renal atrophy lightly.Conclusions： Endourological technique is feasible,effective and the first choice for treatment for upper urinary tract calculous pyonephrosis.