经皮肾微造瘘输尿管镜气压弹道碎石术治疗上尿路结石

Minimally invasive percutaneous nephrolithotomy for the treatment of upper ureteral stone.

目的探讨经皮肾微造瘘输尿管镜气压弹道碎石术(mPCNL)治疗上尿路结石的操作方法和疗效。方法回顾性分析125例应用硬性输尿管镜和气压弹道碎石术治疗上尿路结石患者的资料,其中男71例,女54例;年龄21～75岁,平均43岁。输尿管上段结石43例,肾结石82例,其中2例为行经尿道输尿管镜气压弹道碎石术中向上移位病例,均行经皮肾微造瘘输尿管镜气压弹道碎石术。结果一次性碎石取石108例,两次以上取石17例,114例取尽结石,清除率达91.2%。术后平均住院6.8d,术后随访2周～3个月,肾盂积水由术前(3.2±0.7)cm降至(1.0±0.6)cm(P<0.01),所有病例均无严重并发症发生。结论经皮肾微造瘘输尿管镜气压弹道碎石术治疗上尿路结石效果好,损伤小,并发症少。

Objective To explore the treatment and the efficiency of upper ureteral calculi using minimally invasive percutaneous nephrolithotomy（mPCNL）.Methods We retrospectively reviewed the data of 125 patients（71 males and 54females,with an average age of 43 years） who were underwent mPCNL.Among these patients,43 had stones in the upper,and the others in the kidney.Results 108 patients underwent mPCNL for one time,and 17 patients more than one time.In first stage,114 patients got stone clearance,and the stone-free rate was 91.2%.The mean postoperative hospital stay was 6.8 days.According to the investigation to the patients who made the operation from 2 weeks to 3 months,the hydronephrosis was markedly improved from preoperative（3.2±0.7） cm to postoperative（1.0±0.6） cm according to B-ultrasoud and IVU.All patients did not have serious operative complications.Conclusion mPCNL is mini-invasive and efficient in treatment of upper ureteral calculi,with less complications.