微创经皮肾穿刺取石术治疗嵌顿性输尿管上段结石186例临床体会

Clinical experience of 186 cases of patients with impacted upper ureteral calculi treated with minimally invasive percutaneous nephrolithotomy

目的探讨经皮肾穿刺取石术治疗嵌顿性输尿管上段结石的临床疗效。方法回顾性分析2006年6月～2012年11月期问于我院行经皮肾穿刺取石术治疗的186例嵌顿性输尿管上段结石患者的临床资料。结果全部186例患者均顺利完成手术，手术成功率为100％；其中I期结石取净率为98．4％，总体结石取净率为100％；手术时间为（52．9±5．2）rain，术中出血量为（91．8±33．6）mL，住院时间为（5．3±0．4）d；术后并发症发生率为7．5％；结石复发率为4．4％。结论在具备严格掌握手术适应证并具有熟练的手术操作技术的前提下，采用经皮肾穿刺取石术治疗输尿管上段嵌顿性结石疗效显著，能够有效清除结石，且并发症少，值得临床推广。

Objective To study the clinical efficacy of percutaneous nephrolithotomy on impacted upper ureteral calculi. Methods 186 cases of patients with impacted upper ureteral calculi treated with percutaneous nephrolithotomy from June 2006 to November 2012 in our hospital were analyzed retrospectively. Results The operations of all the 186 patients were successful with a successful rate of 100%; the stone-free rate of phase I was 98.4% and the overall stone-free rate was 100%; the operation time was （52.9 _＋ 5.2） min, intraoperative blood loss was （91.8 ＋ 33.6） mL, length of hospital stay was （5.3 ＋_ 0.4）d, incidence of postoperative complications was 7.5% and the stone relapse rate was 4.4%. Conclusion The clinical efficacy of percutaneous nephrolithotomy on impacted upper ureteral calculi is obvious under the premise of strictly controlling the surgical indications and having skillful operation technique, which can effectively remove the calculi with fewer complications and is worthy of clinical promotion.