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微创经皮肾穿刺造瘘术治疗上尿路疾病
引用本文:李逊,曾国华,吴开俊,陈文忠.微创经皮肾穿刺造瘘术治疗上尿路疾病[J].中华泌尿外科杂志,2004,25(3):169-171.
作者姓名:李逊  曾国华  吴开俊  陈文忠
作者单位:510230,广州医学院第一附属医院微创外科中心泌尿外科
摘    要:目的 探讨微创经皮肾穿刺造瘘术 (PCN)治疗上尿路疾病的可行性。 方法 肾结石90 6例 ,输尿管上段结石 132例 ,肾盂 输尿管连接处 (UPJ)狭窄 87例 ,移植肾结石 2例 ,马蹄肾结石 7例 ,放疗后双侧输尿管狭窄 19例 ,孤立肾结石 2 8例 ,肾结石合并肾囊肿 2例 ,肾脓肿 4 1例 ,利用微创PCN技术治疗。 结果 肾结石取净率 93% (84 2 /90 6 ) ;输尿管上段结石一期 1次取净率 10 0 % (132 /132 ) ;UPJ狭窄平均随诊 7个月 ,成功率 89% (77/87) ;2例移植肾结石和 7例马蹄肾结石均一次取净 ;放疗后输尿管狭窄治疗成功率 89% (17/19) ;孤立肾肾结石 1次取净率 86 % (2 4 /2 8) ;治疗肾结石合并肾囊肿 2例 ,术后随访 6个月囊肿无复发 ;治疗肾脓肿成功率 90 % (37/41)。 结论 微创PCN具有创伤小、出血少的优点 ,扩大了PCN治疗泌尿系疾病的范围 ,疗效良好。

关 键 词:泌尿系疾病  治疗学  经皮肾穿刺造瘘术
修稿时间:2002年8月23日

Minimally invasive percutaneous nephrostomy for treatment of upper urinary diseases
LI Xun,ZENG Guo-hua,WU Kai-jun,et al..Minimally invasive percutaneous nephrostomy for treatment of upper urinary diseases[J].Chinese Journal of Urology,2004,25(3):169-171.
Authors:LI Xun  ZENG Guo-hua  WU Kai-jun  
Institution:LI Xun,ZENG Guo-hua,WU Kai-jun,et al.Department of Urology,Minimally Invasive Surgery Center,First Affiliated Hospital of Guangzhou Medical College,Guangzhou 5102301,China
Abstract:Objective To investigate the feasibility of minimally invasive percutaneous nephrostomy (PCN) for treating upper urinary diseases,such as renal calculi, proximal ureteral calculi,ureteropelvic junction (UPJ) strictures,horseshoe kidney calculi,transplanted kidney calculi,bilateral ureteral strictures following radiotherapy and solitary kidney calculi,renal cysts and renal abscesses. Methods The data of 1224 patients with aforementioned diseases who underwent minimally invasive PCN were retrospectively reviewed. Results Of 906 cases of renal calculi,stone-free results were achieved in 842(93%).100% of stone-free rate at stage 1 was obtained in 132 cases of proximal ureteral calculi,2 cases of transplanted kidney calculi and 7 of horseshoe kidney calculi,respectively.Of 87 cases of UPJ strictures (9 of primary UPJ obstruction and 78 secondary UPJ obstruction or occlusion),success rate was 88%(77/87) with mean follow-up of 7 months.Of 19 cases of bilateral ureteral strictures following radiotherapy,success rate was 89%(17/19).86%(24/28) of stono-free rate at 1 stage was obtained in 28 cases of solitary kidney calculi.Of 41 cases of renal abscesses,the treatment failed in only 4.Of 2 cases of renal cysts,6-months follow-up showed that no recurrent cyst was detected by B-ultrasound. Conclusions Minimally invasive percutaneous nephrostomy has advantages of minimal trauma,less blood loss,rapid recovery and better effect,therefore the therapeutic indications were enlarged for urinary diseases.
Keywords:Urinary diseases  Therapeutics  Percutaneous nephrostomy
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