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目的:探讨去顶输尿管导管在经皮肾镜取石术(PCNL)中的应用价值。方法:患者126例,男73例,女53例,年龄25~72岁,平均43.2岁。左侧65例,右侧53例,双侧8例。均先在输尿管镜下于患侧输尿管置入导丝,循其留置去顶F5输尿管导管,后行PCNL。结果:126例手术均顺利完成,无输尿管导管损伤肾实质致出血等并发症发生。手术时间20~100min,平均60min。术中经皮肾通道顺行留置双J管74例;循输尿管导管逆行置入斑马导丝,在其引导下寻及肾盂开口并顺行留置双J管20例,将斑马导丝自皮肾通道牵至体外、顺行留置双J管21例,循导丝逆行留置双J管11例。结论:PCNL预留去顶输尿管导管安全、便利,有助于提高手术成功率和缩短手术时间,值得临床应用。
Objective: To investigate the value of percutaneous transhepatic ureteral catheterization in percutaneous nephrolithotomy (PCNL). Methods: 126 cases of patients, 73 males and 53 females, aged 25 to 72 years, mean 43.2 years. 65 on the left, 53 on the right, and 8 on both sides. First ureteroscopy in the ipsilateral ureter into the guide wire, followed by indwelling to the top F5 ureteral catheter, after the PCNL. Results: All the 126 operations were successfully completed without complication of renal parenchymal bleeding caused by ureteral catheter injury. Surgery time 20 ~ 100min, an average of 60min. Intraoperative percutaneous renal access to cisplatin double J tube in 74 cases; retrograde transurethral catheterization into zebra guide wire, under its guidance and renal pelvis opening and indwelling double J tube in 20 cases, the zebra guide wire from the skin and kidney Channel pull to the body, in line with double J tube in 21 cases, retrograde wire double J tube in 11 cases. CONCLUSION: PCNL is safe and convenient for the removal of the Ureteral catheter, which helps to improve the success rate of operation and shorten the operation time, which is worthy of clinical application.