摘要
目的:探讨输尿管镜在肾窦内肾盂切开取石治疗复杂形肾结石的临床应用价值。方法:14例复杂形肾结石患者,先行肾窦内肾盂切开取石,直视下或用取石钳尽量取出肾盂、肾盏结石,然后输尿管镜配合碎石机击碎残石。结果:肾窦内肾盂切开取石+输尿管镜下碎石术均获得成功。手术时间127～245分钟,术中出血量50～300ml。11例结石一次性取尽,2例残留小结石自行排出,1例残留结石经ESWL治疗后排出。术中肾盂撕裂2例,术后腹胀4例,发热3例。无大出血、胸膜损伤、肠道损伤、肾蒂损伤、肾周感染、继发性高血压等并发症发生。结论:肾窦内肾盂切开取石+输尿管镜下碎石术治疗复杂形肾结石具有创伤小,并发症少等优点。
Objective：To evaluate the clinical application of ureteroscopic technique dur- ing the intrasinusal pyelolithotomy for com- plex renal calculi. Methods： 14 cases of complex renal calculi were first undergone intrasinusal pyelolithotomy to remove the calculi as possible under direct vision or by lithotomy forceps, then the residual stones were crushed by lithotripter through uretero- scope. Results： The procedures were suc- cessfully performed in 14 cases. Operative time was 127 - 245. The blood loss volume was 50 - 300ml. The rate of complete clear- ante of stones was 78.57% （11/14）, the residual small stones in 2 cases passed out by themselves after the double ＂J＂ tube were pulled out, the residual stones in one cases passed out after ESWL. Expect 2 cases of pyelic laceration,4 abdominal distension and 3 fever, there were no other severe com- plications such so massive hemorrhage, pleural injury,intestinal injury, renal pedicledamage, perirenal infection, secondary hy- pertension, etc. Conclusions ： It is effective and safe in treating complex renal calculi with ureteroscopic technique during the in- trasinusal pyelolithotomy, it not only has a high rate of stones clearance but also reduce the renal damage to minimum.
