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目的:观察经皮肾镜内切开术联合碎石取石术治疗UPJO并肾结石的可行性、疗效及临床应用价值。方法:对25例UPJO并肾结石的患者采用经皮肾镜肾盂内切开术加碎石取石术进行治疗。结果:平均手术时间80min,术中出血量100～500ml,平均住院11.2d。23例患者一次完成手术,2例行Ⅱ期手术处理残石。其中单通道治疗19例,双通道治疗6例,清石率为88%。无大出血等严重并发症发生。随访6个月～3年,UPJO有效率为92%,2例患者术后出现再狭窄,两次内切开无效后改为开放性离断肾盂成形术。结论:经皮肾镜肾盂内切开术联合碎石取石术创伤小,恢复快,疗效确切,是一种治疗UPJO并肾结石的有效方法。
Objective: To observe the feasibility, efficacy and clinical value of percutaneous nephroscope and lithotripsy in the treatment of UPJO and kidney stones. Methods: Twenty-five patients with UPJO and nephrolithiasis were treated with percutaneous nephrolithotomy and lithotripsy. Results: The average operation time was 80 minutes, the blood loss was 100 ~ 500ml and the average hospitalization was 11.2 days. Twenty-three patients completed one operation at a time and 2 patients underwent surgical treatment of residual stone. One single-channel treatment in 19 cases, dual-channel treatment in 6 cases, clear stone rate was 88%. No major bleeding and other serious complications. Follow-up 6 months to 3 years, UPJO effective rate was 92%, 2 patients with restenosis after surgery, ineffective after two open to open interrupted pyeloplasty. Conclusion: Percutaneous nephrolithotomy combined with lithotripsy is a safe and effective method for the treatment of UPJO and kidney stones.