三种微创技术联合治疗复杂性输尿管上段结石的临床研究

Clinical study of three minimally invasive therapies for complicated upper ureteral calculi

目的：探讨复杂性输尿管上段结石的最佳治疗方法。方法对68例复杂性输尿管上段结石患者行三种微创技术联合治疗。结果33例患者行输尿管镜或联合经皮肾镜碎石取石术（MPCNL）和后腹腔镜下输尿管切开取石术（RLU）治疗后，术中取尽结石率为90．9％（30／33）。11例患者行 MPCNL 或联合经尿道输尿管镜碎石取石术（URL）和 RLU 治疗后，术中取尽结石率为100％。24例行腹腔镜切开取石术（RLU），术中取尽结石率为100％。手术均获成功，无严重并发症发生。结论对于复杂性输尿管上段结石的微创治疗，应根据临床情况制定多种个性化治疗方案。

Objective To investigate the best therapy of complicated upper ureteral calculi. Methods A total of 68 patients with complicated upper ureteral calculi underwent combined three mini-mally invasive therapies.Results In the 33 cases selected for ureteroscopy or combined minimally inva-sive percutaneous nephrolithotomy（MPCNL）and retroperitoneal laparoscopic ureterolithotomy（RLU）,the stone-free rate was 90.9%（30 /33）.In the 11 cases selected for MPCNL or combined ureteroscopic litho-tripsy（URL）and RLU,the stone-free rate was 100%.In the 24 cases selected for RLU,the stone-free rate was 100%.All the patients had successful operations without serious complications.Conclusion In the treatment of complicated upper ureteral calculi,multiple individual therapies should be considered accord-ing to the clinical condition.