经皮肾镜联合输尿管镜气压弹道碎石治疗输尿管石街

目的探讨经皮肾镜取石术（percutaneous nephrolithotripsy,PCNL）联合经尿道输尿管镜气压弹道碎石治疗输尿管石街的可行性。方法 2008年3月～2011年10月对27例经B超、KUB、泌尿系CT三维重建等检查确诊的输尿管石街,在输尿管镜下气压弹道加水冲将石街推至肾盂或输尿管上段,再行PCNL。结果 23例1次取石成功,3例2次取石成功,1例因输尿管下端闭锁无法进镜,仅行经皮肾造瘘置管引流术。19例随访3～12个月,平均6个月,8例积水完全消失,7例轻度积水,4例中度积水,无出血、输尿管梗阻、结石复发。结论 PCNL联合输尿管镜气压弹道治疗输尿管石街,疗效确切、安全。

Percutaneous Nephrolithotripsy Combined with Ureteroscopic Pneumatic Lithotripsy for Ureteral Stone Street

Objective To study the feasibility of percutaneous nephrolithotripsy （PCNL） combined with ureteroscopic pneumatic lithotripsy for ureteral stone street. Methods Since March 2008 to October 2011,27 patients were diagnosed with ureteral stone street in our hospital by B-uhrasonography, KUB and CT 3D reconstruction. PCNL was performed on all the patients after the stones were pushed up to the renal pelvis or upper ureter by ureteroscopic pneumatic technique. Results Among the patients, one-session success was achieved in 23 patients, and two-session success was in 3. The other patient was converted to percutaneous nephrostomy drainage, for the lower end of the ureter was closed. A follow-up for 3 to 12 months was achieved in 19 patients （mean, 6 months）, 8 of them showed no hydronephrosis, 7 had mild hydronephrosis, and the other 4 had moderate hydronephrosis; no patient had hemorrhage, ureteral obstruction or recurrent renal calculi during the follow-up. Conclusion PCNL combined with ureteroscopic pneumatic lithotripsy is safe and effective for ureteral stone street.