腔内泌尿技术Ⅰ期或Ⅱ期手术治疗结石性脓肾

目的:探讨运用腔内泌尿外科技术治疗结石性脓肾的疗效和价值.方法:对52例结石性脓肾患者,14例行Ⅰ期手术(包括4例行经皮肾镜取石术;6例经尿道输尿管镜取石术;4例行经皮穿刺肾造瘘引流联合经尿道输尿管镜取石术);38例行Ⅱ期手术,即Ⅰ期经皮肾穿刺造瘘引流,Ⅱ期腔内技术取石术或肾切除术.结果:48例患者肾盂、肾盏漏斗和输尿管梗阻部结石均被取净,6例行肾切除术;无术后大出血和感染性休克等严重并发症;36例随访1～12个月,34例肾功能得到不同程度的恢复.结论:腔内技术安全、有效、微创,保肾率高,应作为结石性脓肾的首选治疗方法,应根据具体情况选择Ⅰ期还是Ⅱ期手术.

Treatment of calculous pyonephrosis with endourological technique first or second stage operation

Objective:To investigate the feasibility and value of the treatment of calculous pyonephrosis with endourological technique.Methods:52 cases of calculous pyonephrosis were treated by endourological technique(14 cases by first stage operation,including 4 cases by percutaneous nephrolithotomy,6 cases by transurethral ureteroscopy and 4 cases by percutaneous nephrostomy and transurethral ureteroscopy;38 cases by second stage operation).36 cases after surgery have been followed and evaluated.Results:The renal or ureteral calculi were cleared after treatment by endourological technique in 48 cases.Nephrectomy was performed in 6 cases.The renal function returned to some extent in 34/36.Conclusions:Endourological surgery had the following merits:safe and effective mini-invasive,the high rate of saving the kidney,so it should be preferred treatment of calculous pyonephrosis.Whether the clinician should perform first operation or second operation depend on patient condition.