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目的评价微创经皮肾镜取石术治疗输尿管上段结石的有效性和安全性。方法2002年2月～2007年10月,应用微创经皮肾造瘘,输尿管镜直视下气压弹道或钬激光碎石治疗168例175侧输尿管上段结石。结果168例均为Ⅰ期碎石、取石,手术时间35～65min,平均45min,结石清除率为100%。术后住院时间4～9d,平均6d。术后发热12例,未出现严重并发症。132例随访3～24个月,平均14个月,无输尿管狭窄及结石残留、复发。结论微创经皮肾镜取石术治疗输尿管上段结石损伤小,并发症少,结石清除率高,尤其适用于结石较大、肉芽包裹嵌顿性输尿管上段结石。
Objective To evaluate the effectiveness and safety of minimally invasive percutaneous nephrolithotomy in the treatment of upper ureteral calculi. Methods From February 2002 to October 2007, 168 cases of upper ureteral calculi were treated with minimally invasive percutaneous nephrostomy, ureteroscopic pneumatic ballistic or holmium laser lithotripsy. Results 168 cases were stage Ⅰ gravel, stone, operation time 35 ~ 65min, an average of 45min, stone clearance rate was 100%. Postoperative hospital stay 4 ~ 9d, an average of 6d. Postoperative fever in 12 cases, no serious complications. 132 cases were followed up for 3 to 24 months, an average of 14 months, no ureteral stricture and residual stones, recurrence. Conclusion Minimally invasive percutaneous nephrolithotomy for the treatment of upper ureteral calculi injury is small, less complications, high rate of stone clearance, especially for larger stones, granulation wrapped incarcerated ureteral stones.