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目的探讨输尿管软镜在上尿路结石中的临床应用价值。方法应用输尿管软镜治疗上尿路结石100例,其中输尿管上段结石15例,肾单发结石38例,肾多发结石35例,肾、输尿管联合结石12例,双侧结石24例,输尿管上段双输尿管畸形并输尿管结石2例,多囊肾合并肾结石2例。结果 100例中4例输尿管软镜鞘不能上行改微经皮肾镜碎石取石术(WPCNL)成功取尽结石,2例多囊肾合并结石输尿管软镜未找到结石之后改WPCNL但穿刺失败,2例术后1月来院拔管时发现输尿管中下段石街形成再次入院在硬膜外麻醉下行输尿管镜取石术,平均手术时间96(25~185)min,术中、术后无活动性出血,无1例输血。结石取尽率92%。结论应用输尿管软镜治疗上尿路结石具有安全简便、结石取尽率高、创伤小、并发症少等优点,可作为上尿路结石常用腔内治疗的有益补充,然而对手术技巧的掌握,配套设施的保障是手术成功的关键。
Objective To investigate the clinical value of ureteroscopy in upper urinary tract calculi. Methods 100 cases of upper urinary tract calculi were treated with ureteroscope, including 15 cases of upper ureteral calculi, 38 cases of single renal calculus, 35 cases of multiple calculi, 12 cases of renal and ureteral calculi, 24 cases of bilateral calculi, upper ureter double 2 cases of ureteral deformity and ureteral stones, 2 cases of polycystic kidney disease combined with kidney stones. Results In the 100 cases, 4 cases of ureteroscope sheath could not be surgically modified, and percutaneous nephrolithotomy (WPCNL) was successfully performed. Two cases of polycystic kidney disease complicated with ureteral calculi failed to find the stone, Two cases of extubation in January after surgery found that the stone in the middle and lower ureteral formation was re-admitted to hospital under epidural anesthesia ureteroscopic lithotomy, the average operation time 96 (25 ~ 185) min, intraoperative and postoperative no active bleeding No one transfusion. Stone exhaustion rate of 92%. Conclusions The ureteroscopic treatment of upper urinary calculi has the advantages of safety and simplicity, high exhaustion of stones, less trauma and less complications, which can be used as a useful supplement for endovascular treatment of upper urinary calculi. However, mastery of surgical techniques, Support facilities is the key to the success of surgery.