上尿路结石并发真菌感染的微创经皮肾镜治疗

Minimally invasive treatment of the upper urinary tract stones with fungal infection

目的 :探讨输尿管镜和微创经皮肾镜探察取石术 ,以及术后局部灌注抗真菌药治疗上尿路结石并发真菌感染的有效性。方法 :对 4 9例上尿路结石并发真菌感染患者 ,采用输尿管镜探察和微创经皮肾镜取石术后经皮肾微造瘘管或输尿管外支架管灌洗抗真菌药治疗。结果 :4 9例真菌感染均得到较好控制 ,尿液真菌培养阴性 ;4 5例结石取净 ,术后肾功能有不同程度的恢复 ,无一例出现大出血和真菌败血症。结论 :输尿管镜探察和微创经皮肾镜取石术 ,以及术后局部灌注抗真菌药治疗上尿路结石并发真菌感染 ,是一种微创安全并能同时取石和控制感染的可靠方法。

Objective:To explore the effects of ureteroscopy(URS) and minimally invasive percutaneous nepholithotomy(mini-PCNL) combination with direct irrigation of renal pelvis in treating the upper urinary tract stones with fungal infection.Method:From Jan,1998 to Ocb, 2003, 49 cases of lithiasis with fungal infectiong were treated by URS and mini-PCNL with antifungal irrigation through nephrostomy tubes or ureteral stents.Result:All cases of infection were controlled and culture was negative. 45 cases were stone-free, and no hemorrhea and fungemia happened.Conclusion:URS and mini-PCNL with antifungal irrigation treating the upper urinary tract stones with fungal infection was a safe,less invasive and dependable modality.