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目的探讨经皮肾镜超声碎石治疗肾结石合并同侧输尿管上段结石的安全性及有效性。方法肾结石合并同侧输尿管上段结石患者35例,均给予经皮肾镜超声碎石治疗。观察手术时间、术中出血量、结石清除率及术后并发症发生情况等。结果均顺利完成手术,无中转开放手术。术中发现2例合并肾盂输尿管连接部狭窄,行球囊扩张术,术后放置“留置佳”双J管。术中出血量15~200 m L,平均48.6 m L;手术时间30~155 min,平均64.4 min,术后平均住院时间7 d。复查肾脏-输尿管-膀胱(KUB)平片无明显结石残留,结石清除率达100%;术后无明显大出血、感染、高热等并发症,均痊愈出院。结论经皮肾镜超声碎石是治疗肾结石合并输尿管上段结石的一种安全有效的方法,损伤小、恢复快、效果好,值得推广应用。
Objective To investigate the safety and efficacy of percutaneous nephrolithotomy lithotripsy in the treatment of upper ureteral calculi associated with kidney stones. Methods 35 cases of renal calculi with ipsilateral ureteral calculi, were treated with percutaneous nephrolithotomy. Observation of operation time, intraoperative blood loss, stone clearance and postoperative complications occurred. The results were successfully completed surgery, no transit open surgery. Intraoperative findings of 2 cases of ureteropelvic junction stenosis, line balloon dilatation, postoperative placement “good” double J tube. Intraoperative blood loss 15 ~ 200 m L, an average of 48.6 m L; operation time 30 ~ 155 min, an average of 64.4 min, average postoperative hospital stay 7 d. Reexamination of kidney - ureter - bladder (KUB) plain film no obvious residual stones, stone clearance rate of 100%; no significant postoperative bleeding, infection, fever and other complications, were cured and discharged. Conclusion Percutaneous nephrolithotomy is a safe and effective method for the treatment of upper ureteral calculi associated with renal calculus. It is less invasive, quicker and effective and should be widely applied.