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目的探讨B超引导经皮肾镜超声碎石清石术治疗输尿管上段嵌顿性结石的方法、疗效及其安全性。方法回顾性分析采用B超引导经皮肾镜超声碎石清石术治疗48例输尿管上段嵌顿性结石患者的临床资料,对其方法、临床疗效及手术并发症等资料进行评价。结果 48例患者均一期成功建立经皮肾通道,手术时间30~55 min,平均46 min,术后3d内体温≥38.5℃者5例,占10%,无血气胸、腹腔脏器损伤等严重并发症发生。术后1周复查44例患者取尽结石,一期结石清除率92%,4例患者因肾盏结石残留给予体外冲击波碎石治疗,术后3个月复查结石清除率100%。结论 B超引导经皮肾镜超声碎石清石术治疗输尿管上段嵌顿性结石方法可行,疗效安全、可靠。
Objective To investigate the efficacy and safety of B-guided percutaneous nephrolithotomy lithotripsy in the treatment of upper ureteral incarcerated stones. Methods The clinical data of 48 patients with upper ureteral incarcerated stones treated with B-guided percutaneous nephrolithotomy lithotripsy were retrospectively analyzed. The methods, clinical efficacy and surgical complications were evaluated. Results All the 48 patients were successfully treated with percutaneous renal access in one phase. The operation time was 30-55 minutes (mean 46 minutes). In the third day after operation, the body temperature was 38.5 ℃ (5%), accounting for 10%. No pneumothorax and abdominal organ injury were serious Complications occur. One week after operation, 44 patients were examined for stone exhaustion, 92.9% for stage I stone, and 4 cases were treated with extracorporeal shock wave lithotripsy due to residual calyceal calculus. The stone clearance rate was 100% at 3 months after operation. Conclusion B-guided percutaneous nephrolithotomy lithotripsy for the treatment of upper ureteral incarcerated stones feasible, safe and reliable.