经皮肾镜气压弹道联合超声碎石治疗上尿路感染性结石

目的探讨经皮肾镜治疗输尿管上段结石及肾结石并感染的疗效。方法对肾、输尿上段结石并感染较轻者,经控制感染后I期行经皮肾镜气压弹道联合超声碎石术37例;合并较严重感染者先期行经皮肾造瘘、Ⅱ期经皮肾镜气压弹道联合超声碎石术17例。结果 I期行经皮肾镜气压弹道联合超声碎石术37例中,4例术后出现高热(>39℃),7例术后体温在38℃～39℃,其余26例术后体温<38℃。Ⅱ期经皮肾镜气压弹道联合超声碎石术17例,所有病例Ⅱ期经瘘道碎石取石术后体温均<38℃。结论对于输尿管上段及肾结石并感染患者,经抗炎治疗后复查,血象、体温正常,无腰痛,估计手术时间较短者,选择I期经皮肾镜碎石取石术;否则,选择Ⅱ期经皮肾镜术。

The Treatment of Percutaneous Nephrostomy with Pneumatic and Ultrasonic Lithotripsy for the Upper Urinary Tract Infection Stones

Objective To summarize the clinical experience of percutaneous nephrostomy with pneumatic and ultrasonic lithotripsy for the treatment of upper urinary tract infection stones.Methods Thirty-seven cases of upper ureteral stone and renal stone with gentle infection were treated with one-stage percutaneous nephrostomy with pneumatic and ultrasonic lithotripsy.Seventeen cases with severe infection were treated with two-stage percutaneous nephrostomy with pneumatic and ultrasonic lithotripsy.Results In the thirty-seven cases with one-stage percutaneous nephrostomy with pneumatic and ultrasonic lithotripsy,four cases suffered from fever over 39 ℃ and seven cases with 38 ℃～39 ℃ after operation,the temperature of twenty-six cases was below 38 ℃.In the seventeen cases with two-stage percutaneous nephrostomy with pneumatic and ultrasonic lithotripsy,the temperature of all cases was below 38 ℃ after operation.Conclusion For the patients of upper ureteral stone and renal stone with infection,the cases with normal hemogram,normal temperature,no lumbago and little operating time forecasted can be treated with one-stage percutaneous nephrostomy with pneumatic and ultrasonic lithotripsy.Otherwise,they should be treated with two-stage percutaneous nephrostomy with pneumatic and ultrasonic lithotripsy.