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目的:探讨分析上尿路结石致重度肾积水的临床治疗方法及最大可能保肾的可行性。方法:选取我院2011年5月~2012年5月收治的50例上尿路结石致重度肾积水患者的临床资料进行回顾性的分析,首先对所有患者进行皮肾穿刺造瘘解除梗阻,再按照患者的不同病情有针对性的、择期的采用微创经皮肾镜取石术、输尿管镜气压弹道碎石术、开放手术取石或肾切除手术进行治疗。结果:50例患者中采用微创经皮肾镜取石术(MPCNL)的有31例,采用输尿管镜气压弹道碎石术(URL)的有11例,采用开放手术取石的有6例,采用肾切除手术的有2例;不同手术方法治疗的患者人数差异较显著,具有统计学意义(P<0.05)。结论:对上尿路结石致重度肾积水患者的治疗,先进行皮肾穿刺造瘘解除梗阻,再根据所患结石部位、大小等具体情况的不同采用不同的手术方式,不仅可以确保安全性,还能够更好的帮助患者治疗,是一种非常合理的治疗方式,值得推广。
Objective: To investigate the clinical treatment of severe hydronephrosis caused by upper urinary tract calculi and the feasibility of maximizing kidney-invigoration. Methods: The clinical data of 50 patients with severe hydronephrosis caused by upper urinary calculi in our hospital from May 2011 to May 2012 were retrospectively analyzed. First, all patients were obstructed by percutaneous nephrostomy, In accordance with the patient’s different conditions and then targeted, elective use of minimally invasive percutaneous nephrolithotomy, ureteroscopic pneumatic lithotripsy, open surgery stone or nephrectomy for treatment. RESULTS: Thirty-one of the 50 patients underwent minimally invasive percutaneous nephrolithotomy (MPCNL), 11 underwent ureteroscopic pneumatic lithotripsy (URL), 6 underwent open surgery, There were 2 cases of resection surgery; the number of patients treated by different surgical methods was significantly different, with statistical significance (P <0.05). Conclusions: For the treatment of patients with severe hydronephrosis caused by upper urinary tract stones, the patients should be treated with a first nephroureterectomy to remove the obstruction, and then different surgical methods should be adopted according to the specific conditions such as the site and size of the stones involved, not only to ensure safety , But also to better help patients with treatment, is a very reasonable treatment, it is worth promoting.