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目的探讨微创腔镜治疗上尿路结石合并肾盂内尿液感染的临床效果。方法对2009年9月~2015年9月新疆自治区人民医院泌尿外科经实验室及影像学检查确诊的91例上尿路结石合并肾盂内尿液感染的患者的病历资料进行回顾性的临床分析。11例行输尿管软镜下钬激光碎石术,28例行输尿管硬镜下输尿管结石碎石术,27例患者行I期经皮肾镜取石术,18例行经皮肾穿刺造瘘引流术,7例患者行经输尿管镜支架置入术。结果 91例患者中,66例(73%)肾功能得以不同程度的恢复,I期结石取净者50例,残留碎石41例,二期结石取净者29例,三期结石取净者11例,1例Ⅱ期肾切除术。术后随访1~12个月无复发。结论微创腔镜技术对上尿路结石合并肾盂内尿液感染进行治疗效果良好,个体化治疗上尿路结石合并肾盂内尿液感染,大大提高手术成功率。
Objective To investigate the clinical effect of minimally invasive endoscopic treatment of upper urinary tract stones combined with intra-renal urine infection. Methods The clinical data of 91 patients diagnosed as upper urinary tract calculi with intra-pelvic urine infection confirmed by laboratory and imaging examination from September 2009 to September 2015 in Urology of People’s Hospital of Xinjiang Uygur Autonomous Region were retrospectively analyzed. 11 cases of ureteroscopic holmium laser lithotripsy, 28 cases of ureteral calculi lithotripsy, 27 patients with stage I percutaneous nephrolithotomy, 18 cases of percutaneous nephrostomy drainage , 7 patients underwent ureteral stent placement. Results Of the 91 patients, 66 cases (73%) had different degrees of recovery of renal function. Fifty cases of stage I stone removed, 41 cases of residual gravel, 29 cases of stage II calculi, 11 cases, 1 case of stage II nephrectomy. Follow-up 1 to 12 months after surgery without recurrence. Conclusion The minimally invasive endoscopic technique is effective in treating upper urinary tract stones with intra-renal pelvic infection. Individualized treatment of upper urinary tract stones combined with intra-renal urine infection greatly improves the success rate of surgery.