经皮肾镜联合输尿管镜一期治疗上尿路结石23例临床研究

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1、经皮肾镜联合输尿管镜一期治疗上尿路结石23例临床研究［摘要］目的探讨斜仰卧截石位下经皮肾镜联合输尿管镜一期治疗上尿路结石的临床应用。方法2012〜2013年我科23例患者于全麻下采取斜仰卧截石位一期经皮肾镜联合输尿管镜行碎石取石术。23例患者中16例先行输尿管镜下碎石取石再行经皮肾镜碎石取石，7例患者同时分别进行经皮肾镜碎石取石及输尿管镜下碎石取石。结果23例患者术中术后均未输血，术中术后未发生感染性休克，无患者术中终止手术，无患者术中转开放手术。术后3d复查腹平片显示仅3例患者存在直径小于3mm结石残留，其余患者均无

2、结石残留。23例患者术后肾功能复查均正常。结论经皮肾镜联合输尿管镜一期治疗上尿路结石具有多种优点，选择合适的病例采用此法治疗上尿路结石，特别是肾结石合并输尿管结石是可行且有效的。［关键词］经皮肾镜技术；输尿管镜；泌尿系结石；碎石分类号］R693.4［文献标识码］B［文章编号］2095-0616(2013)22—159—03Percutaneousnephrolithotripsycombinedureterorenoscopelithotripsysimultaneouslytotreattheupperurinary

3、tractstonesof23casesYANGXiaojieZHANGDongLUOQidongDepartmentofUrology,theSecondAffiliatedHospitalofXi’anJiaoTongUniversityMedicalCollege,Xi’an710004,China[Abstract]ObjectiveToexploretheclinicalapplicationofPercutaneousnephrolithotripsycombinedureterorenoscopelith

4、otripsysimultaneouslytotreattheupperurinarytractstonesatlithotomyanaclisisposition.MethodsFrom2010to2013,23patientsinourdepartmentundertakepercutaneousnephrolithotripsycombinedureterorenoscopelithotripsysimultaneouslytotreattheupperurinarytractstonesatthelithoto

5、myanaclisisposition.16caseshaveureterorenoscopelithotripsyfirstandthenpercutaneousnephrolithotripsy.7caseshavethebothsimultaneously.ResultsThetotal23casesnonehavebloodtransfusion,nonehaveinfectiousshock,noneterminatetheoperationduringtheprocedure,noneturntoopens

6、urgery.TheKUBplainfilmaftersurgeryshowsonly3caseshaveresidualstones,butthediameterofthestoneswaslessthan3centimeters.Allcasesshowsnormalkidneyfunctionaftersurgery.ConclusionPercutaneousnephrolithotripsycombinedureterorenoscopelithotripsysimultaneouslytotreattheu

7、pperurinarytractstonesatlithotomyanaclisispositionisasplendidsurgery.Withsuitablecases,especiallykidneystoneincorporatewithureterstone,thissurgeryisfeasibleandavailable.[Keywords]Percutaneousnephrolithotripsy；Ureterorenoscope；Lithotripsy；Upperurinarytract泌尿系结石为泌

8、尿外科常见病及多发病之一，泌尿系结石的治疗现在已步入了微创时代，经皮肾镜碎石取石术、输尿管镜下碎石取石术现已成为泌尿系上尿路结石治疗的主导方法。然而，无论是经皮肾镜技术或者是输尿管镜下碎石取石术均有一定的局限，联合应用经皮肾镜技术与输尿管镜进行上尿路结石的治疗，可以相互弥补不足，迗到一期有效治疗结石的目的。我科自2012年1月〜2