顺行＋逆行输尿管镜技术治疗复杂性输尿管上段结石

Anterograde and retrograde ureteroscopy in treating complicated upper ureteral calculi

目的探讨顺行＋逆行输尿管镜技术治疗复杂性输尿管上段结石的疗效和安全性。方法对90例复杂性输尿管上段结石患者采用逆行经尿道输尿管镜和顺行经皮输尿管镜联合碎石取石的治疗方法，其中经尿道输尿管镜配合气压弹道碎石及上推结石，经皮输尿管镜配合高压水冲取石。结果90例输尿管结石一次碎石成功率为94％（85／90），全部患者未出现明显的大出血、假道、穿孔、尿路感染等并发症，无一例患者需要输血治疗。结论顺行＋逆行输尿管镜技术治疗复杂性输尿管上段结石具有损伤小、手术安全、取石方便、残石率低等优点，值得进一步推广。

Objective To investigate the efficacy and safety ureteroscopy in treating complicated upper ureteral calculi. Methods of anterograde and retrograde Ninety patients with compli- cared upper ureteral calculi were treated by anterograde and retrograde ureteroscopy, including tran- surethral ureteroscopy supplemented with pneumatic lithotripsy and push stones, and percutaneous ureteroscopy supplemented with high-pressure water jetting stone removal. Results The first time success rate of lithotripsy for 90 cases of ureteral calculi was 94% （85/90）. None of the patient had complications, such as significant hemorrhage, urethral false passage, perforation, or urinary tract infections, and no blood transfusion treatment was required. Conclusions The treatment of compli- cated upper ureteral calculi by anterograde and retrograde ureteroscopy has the advantages of minor injury, safe surgery, convenient stone removal and low residual stone rate, which is worthy of further promotion.