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目的探讨经皮肾镜治疗开腹手术后肾、输尿管上段残余或复发结石的疗效。方法对46例开腹手术后肾、输尿管上段残余或复发结石,先经尿道输尿管镜插入单J管,术中造成人为肾积水,一般选肾中、上盏穿刺造漏成功,输尿管镜找到结石,用气压弹道碎石机打碎结石,钳子夹出结石,置肾造漏管。结果1次取净结石20例(43.4%),2次取净15例(32.6%),3次取净8例(17.3%),残余结石3例(6.5%),残余结石大小0.1 cm×0.1 cm×0.2 cm~0.5 cm×0.5 cm×0.6cm。单通道取出18例(39.1%),双通道取出20例(43.5%),三通道取出8例(17.4%)。结论经皮肾镜取石治疗开腹手术后残余或复发结石创伤小,疗效好。
Objective To investigate the effect of percutaneous nephrolithotomy on residual or recurrent stones in the upper ureter and proximal ureter after laparotomy. Methods 46 cases of open surgery after kidney, ureter residual or recurrent stones, ureteroscopy ureter first inserted into a single J tube, resulting in artificial hydronephrosis during surgery, the general election of kidney, the puncture on the puncture to create leakage, ureteroscopy found Stones, broken stone with pneumatic lithotripsy, pliers folder out of stones, kidney-made drain tube. RESULTS: Twenty patients (43.4%) were treated with net stones in one time, 15 (32.6%) were removed twice, 8 (17.3%) were removed in 3 times and 3 (6.5%) were residual stones. 0.1 cm × 0.2 cm to 0.5 cm × 0.5 cm × 0.6 cm. 18 cases (39.1%) were removed in one channel, 20 cases (43.5%) were removed in dual channel and 8 cases (17.4%) were removed in three channels. Conclusion Percutaneous nephrolithotomy for traumatic residual or recurrent stones after open surgery is less invasive and has good curative effect.