急诊经皮肾镜输尿管镜手术在上尿路梗阻性疾病的应用

Percutaneous Nephroscopy and Ureteroscopy in the Treatment of Upper Urinary Tract Obstruction

目的:探讨急诊经皮肾镜、输尿管镜手术在上尿路梗阻性疾病的应用价值。方法:分析28例急诊经皮肾镜、输尿管镜手术患者的临床资料。包括复杂型肾结石并脓肾5例,输尿管结石并患侧肾积水22例(其中合并肾后性肾功能衰竭3例,患侧肾周积液、尿外渗6例,顽固性肾绞痛10例),孤立肾伴肾后性肾功能衰竭、输尿管上段肿瘤1例。行急诊经皮肾穿刺造瘘术12例、输尿管镜钬激光碎石术10例、输尿管镜下内支架管置入术6例。结果:28例手术均成功进行,术后患者肾功能明显改善,尿外渗、肾周积液减轻,脓肾消失,肾积水明显好转,顽固性肾绞痛消失。5例复杂型肾结石及10例输尿管上段结石患者行二期PCNL术,1例行输尿管肿瘤姑息性切除术。结论:急诊经皮肾镜、输尿管镜手术具有微创、安全、有效等特点,对治疗上尿路梗阻性疾病有重要价值。

Objective： To study the value of percutaneous nephroscopy（PCN） and ureteroscopy in the treatment of upper urinary tract obstruction（UUTO） under emergency.Method：Clinical data of 28 patients of UUTO that underwent PCN or ureteroscopy before completely treatment for relieving of obstruction were respectively reviewed.Result：PCN or ureteroscopy were successively performed in the 28 cases.All of the cases renal function were improved after PCN or ureteroscopy.Conclusion：PCN and ureteroscopy is minimally invasive,safety,effective and applicable in the treatment of UUTO under emergency.