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目的:探讨双侧全程尿路结石的微创治疗方法。方法:回顾性报告3例因双J管留置时间过长或下尿路梗阻继发双侧全程尿路结石患者的微创分期治疗过程,并复习有关文献予以讨论。结果:3例患者均为膀胱、双侧输尿管及双侧肾结石患者,入院后先行ESWL,然后再行手术治疗。一期利用输尿管镜碎石取石(uret-erorenoscope lithotripsy,URL)处理膀胱及双侧输尿管结石,二期采用经皮肾镜碎石取石(percutaneous nephro-lithotomy,PCNL)将双侧肾及双侧输尿管上端结石清理干净,并将滞留的双J管顺利拔除。术后复查结石基本清理干净,肾功能好转,患者症状均消失。结论:输尿管镜碎石取石术处理膀胱及输尿管中下段结石,结合二期经皮肾镜碎石取石术处理肾及输尿管上段结石,是治疗双侧全程尿路结石的理想选择,值得推广。
Objective: To explore the minimally invasive treatment of bilateral urinary tract stones. Methods: We retrospectively reported the minimally invasive staging of 3 patients with bilateral total urinary tract stones secondary to double J tube indwelling time or lower urinary tract obstruction, and reviewed the relevant literature for discussion. Results: All three patients were bladder, bilateral ureter and bilateral renal calculi. After admission, ESWL was performed before surgery. One case was treated with ureteroscope lithotripsy (URL) for bladder and bilateral ureteral calculi, and the other two cases were treated with percutaneous nephro-lithotomy (PCNL) Clean up the stones on the top, and the double J tube detained successfully removed. Postoperative review of the basic clean-up stones, renal function improved, the patient’s symptoms disappeared. Conclusions: Ureteroscopic lithotripsy for the treatment of lower urinary calculi in the bladder and ureter combined with second stage percutaneous nephrolithotripsy is an ideal choice for the treatment of bilateral urinary calculi and is worthy of promotion.