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目的探讨超声引导下微通道经皮肾输尿管镜钬激光碎石术治疗复杂性输尿管上段结石的临床疗效。方法对42例复杂性输尿管上段结石患者的临床资料进行回顾性分析,采用超声引导下微通道经皮肾输尿管镜钬激光碎石术治疗,对结石取净率、并发症情况进行分析探讨。结果 42例患者成功施行经皮肾穿刺并建立经皮肾微通道,一期取石33例,结石取净率为82.5%,手术时间50~120 min。并发症主要为发热感染症状,发生率为4.8%;术后随访3~6个月,2例患者结石复发,ESWL治疗2~3次痊愈。结论超声引导下微通道经皮肾输尿管镜钬激光碎石术治疗复杂性输尿管上段结石损伤小、并发症少、结石一次清除率高,值得临床推广应用。
Objective To investigate the clinical effect of ultrasound-guided percutaneous nephrolithotomy with holmium laser lithotripsy in the treatment of complex upper ureteral calculi. Methods The clinical data of 42 patients with complicated upper ureteral calculi were analyzed retrospectively. Ultrasound-guided percutaneous nephrolithotomy with holmium laser lithotripsy was used to analyze the rate of stone removal and complications. Results Twenty-four patients underwent percutaneous nephrostomy and established percutaneous renal microchannel. One stage stone was taken in 33 cases. The stone removal rate was 82.5% and the operation time was 50 to 120 minutes. Complications were mainly fever infection, the incidence was 4.8%; postoperative follow-up of 3 to 6 months, 2 patients with stone recurrence, ESWL treatment 2 to 3 times cured. Conclusion Ultrasound-guided percutaneous nephrolithotomy with holmium laser lithotripsy for the treatment of complex upper ureteral calculi has fewer injuries and fewer complications, and the primary clearance rate of stones is high, which is worthy of clinical application.