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目的:探讨微创经皮肾造瘘输尿管镜取石术治疗上尿路结石的临床疗效。方法:通过微创经皮肾造瘘通道,对176例肾结石,42例输尿管上段结石实施气压弹道碎石取石术。结果:218例患者中,单通道治疗197例(90.3%),双通道治疗21例(9.7%),一期取石189例(86.7%),二期取石29例(13.3%)。结石取尽率为92.6%(202/218)。除1例结肠损伤改行开放手术,1例术后严重出血经超选择肾动脉栓塞治愈外,无严重并发症发生。结论:微创经皮肾造瘘输尿管镜取石术创伤小,结石清除率高,并发症少,是治疗上尿路结石的安全有效的方法。
Objective: To investigate the clinical effect of minimally invasive percutaneous nephrostomy ureteroscopic lithotripsy in the treatment of upper urinary tract calculi. Methods: By means of minimally invasive percutaneous nephrostomy, pneumatic lithotripsy was performed on 176 renal calculi and 42 upper ureteral calculi. Results: Among the 218 patients, 197 cases (90.3%) were treated with single-channel therapy and 21 cases (9.7%) with dual-channel therapy. 189 cases (86.7%) were treated with one stage stone and 29 cases (13.3%) with stage two stone. The rate of stone extraction was 92.6% (202/218). In addition to 1 case of colon injury diverted open surgery, 1 case of severe bleeding after the over-selection of renal artery embolization cure, no serious complications. Conclusions: Minimally invasive percutaneous nephrostomy ureteroscopic lithotripsy is a safe and effective method for the treatment of upper urinary tract stones with small trauma, high stone clearance rate and few complications.