微创经皮肾镜取石术同期治疗双侧输尿管上段结石的疗效分析

目的：评价微创经皮肾镜取石术（MPCNI，）同期治疗双侧输尿管上段结石的有效性及安全性。方法：回顾性分析我院2005年10月～2009年7月共收治22例双侧输尿管上段结石患者的临床资料，全部患者均行微创经皮肾镜取石术。结果：22例患者（44例侧）一次穿刺成功，17例患者一次取净双侧结石，5例患者术后复查一侧残存肾内结石碎粒，其中4例口服排石药物，一个月后复查结石大部分排空，少量残留。1例患者于术后结合ESWL排净结石，手术结石取净率88．6％。平均手术时间（98．9±24．2）min，术中估计出血量平均（240．5±108．1）ml，术后肾造瘘管留置1～2天，术后平均住院时间（4．8±1．3）天。结论：对于身体条件良好，结石相对容易清除的双侧输尿管上段结石。同期MPCNL是安全有效的。

Therapeutic Effect Analysis of Simultaneously Minimally Invasive Percutaneous Nephrolithotomy in Treatment of Bilateral Proximal Ureteral Stones

Objective：To evaluate the effect and safety of simultaneously minimally invasive percutaneous nephrolithotomy（MPCNL） in treatment of bilateral proximal ureteral stones. Methods.. Retrospectively analyzed the data of 22 cases of bilateral proximal ureteral stones patients in our hospital from October 2005 to July 2009. Of the 22 patients,14 were male and 8 were female. The diameter of stones was 0.8 cm to 2.6 cm. All the cases had undergone MPCNL. Results： MPCNL was completed in all 22 cases. 17 cases had been moved the bilateral stones clearly. Residual calculi were found in 5 cases of one side after operation and 4 cases use medical drags to treat. The most residual calculi of 4 cases were found removed after 1 month and a less stones being survived. 1 cases with residual calculi were treated by ESWL. The total stone clearance was 88.6%. The average operation time was 98.9±24.2 min. The blood loss during the operation was 240.5 ±108.1 mL. Nephrostomy tube was kept for a mean of 1-2 days. The mean post operational hospital stay was 4.8 ±1.3 days. Conclusions：It is effective and safe for simultaneously minimally invasive percutaneous nephrolithotomy in treatment of the patients of bilateral proximal ureteral stones with well genral status and relative easy of removed stones.