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目的:探讨原位尿流改道术后输尿管下段结石的治疗方法。方法:2003年2月~2012年7月,采用经皮肾穿刺、顺行金属导丝引导的输尿管镜取石术,对9例男性原位尿流改道术后输尿管下段结石的患者进行治疗。结果:9例手术均获得成功,其中7例在顺行置入金属导丝的引导下完成输尿管镜碎石取石术,另外2例因结石嵌顿,放置导丝在输尿管软镜的辅助下完成取石术。8例术后随访3~12个月,KUB、IVU及CT检查显示,结石排净,肾脏积水明显改善。结论:经皮肾穿刺、顺行导丝引导下的输尿管镜取石术治疗原位尿流改道术后输尿管下段结石疗效确切、安全性高、创伤性小、住院时间短,为原位尿流改道术后输尿管下段结石的患者提供了新的有效治疗方法。
Objective: To investigate the treatment of ureteral calculi after orthotopic urinary diversion. Methods: From February 2003 to July 2012, 9 patients with ureteral calculi undergoing primary urinary diversion were treated with percutaneous renal puncture and ureteroscopic guided lithotomy guided by metallic wire. Results: All of the 9 surgeries were successful. Among them, 7 cases underwent Ureteroscopic lithotripsy under the guidance of metal guide wire, and the other 2 cases were performed with ureteral soft-lens Stone surgery. Eight patients were followed up for 3 to 12 months. The KUB, IVU and CT findings showed that stones were drained and kidney water was significantly improved. Conclusion: Percutaneous nephrolithotomy and ureteroscopic lithotripsy guided by anterograde guide wire are effective in treating lower ureteral calculi after orthotopic urinary diversion. High safety, less invasiveness and short hospital stay are the primary urinary diversion Postoperative patients with lower ureteral calculi provide a new and effective treatment.