经皮肾穿刺输尿管镜治疗输尿管上段石街

目的探讨经皮肾穿刺输尿管镜治疗ESWL后输尿管上段石街的疗效及安全性。方法采用经皮肾穿刺输尿管镜气压弹道超声碎石治疗ESWL术后输尿管上段石街患者46例。男27例,女19例;平均年龄39例。石街长3.2～5.5 cm,平均3.6 cm。左侧18例,右侧28例。合并轻中度肾积水39例、重度肾积水4例,合并脓肾3例。统计手术时间、结石清除率、肾造瘘管留置时间、住院天数、术中出血和并发症等情况。术后1～2 d复查KUB,1～2周复查IVU。了解结石残留及肾功能恢复情况。结果46例平均手术时间62 min,术中估计失血量20～100 ml,平均30 ml,未出现严重并发症。一期结石清除率100%,肾造瘘管留置时间平均4 d,平均住院时间6 d。随访40例,随访时间1～6个月,KUB、IVU未发现残留结石、输尿管狭窄;患者肾功能均有不同程度恢复。结论微创经皮肾穿刺输尿管镜碎石清除术治疗ESWL术后输尿管上段石街安全有效。

Percutaneous nephrolithotomy in treating upper ureteric stone street after ESWL

Objective To evaluate the safety and efficacy of minimally invasive percutaneous nephrolflhotomy(mini-PCNL)with ultrasonic and pneumatic lithotripter in treating upper ureteric stone street after ESWL.Methods Data from 46 patients who underwent mini-PCNL with ultrason- ic and pneumatic lithotripter for upper ureterie stone street after ESWL were reviewed.There were 27 male patients and 19 female with an average age of 39.Eighteen had upper ureteral stone-street of left side and 28 of right side.The length of stone street was 3.2-5.5 cm.The time of the operation,stone clear rate,retention time of nephrostomy tube,time of hospital stay,blood loss and complications were evaluated.Results The average time of the operation was 62 min.Average blood loss was 30 ml.No blood transfusion needed and no severe complication occured.Stone clear rate was 100%.Av- erage retention time of nephrostomy tube was 4 days,and average hospital stay was 6 d.Forty cases were followed-up for 1 to 6 months.No stone remain or ureteral stricture has been observed by intrave- nous urography.Conclusions Minimally invasive percutaneous nephrolithotomy with ultrasonic and pneumatic lhhotripter could be safe and effective in treating upper ureteric stone street after ESWL.