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目的:探讨双输尿管导管在减少同侧输尿管上段扩张时经皮肾镜取石术中结石碎片下移至输尿管中下段的有效性。方法:2010年3月~2014年11月采用经皮肾镜取石术(PCNL)治疗合并输尿管扩张的上尿路结石患者18例,术中同侧输尿管先插入两条F5输尿管导管,然后行PCNL,观察术中有无因小结石移位至输尿管中下段而导致输尿管内支架无法置入;术后复查KUB观察有无大于4mm结石碎片残留于输尿管中下段。结果:1例因结石下移至输尿管下段需翻身改截石位,经输尿管镜将下段结石击碎取出后才能留置输尿管内支架;17例均顺利完成PCNL,术后KUB发现1例患者输尿管下段石街形成且有两粒结石碎片大于4mm。结论:对于输尿管扩张的上尿路结石,行PCNL时插入两条输尿管导管,有助于减少结石碎片下移至输尿管中下段。
OBJECTIVE: To investigate the effectiveness of dual ureteral catheter in reducing the fragments of stones in percutaneous nephrolithotomy and the lower ureter during the expansion of the upper ureter. Methods: From March 2010 to November 2014, 18 patients with upper urinary tract calculus with ureteral dilatation were treated with percutaneous nephrolithotomy (PCNL). Two F5 ureteral catheters were inserted into the ipsilateral ureter first and then the PCNL , To observe whether the operation due to small stones translocation to the ureter in the lower ureter caused by the stent can not be placed; KUB observation postoperatively more than 4mm stone fragments remain in the lower ureter. Results: 1 case of stone removed to the lower ureter to turn over to change the lithotomy position, ureteroscopic lithotomy will be removed after the lower ureteral stent can be placed; 17 cases were successfully completed PCNL, KUB found 1 case of lower ureteral ureter Stone Street and the formation of two stone fragments greater than 4mm. Conclusions: For upper ureteral calculi with ureteral dilatation, insertion of two ureteral catheters during PCNL helps to reduce the incidence of stone fragments moving down to the lower ureter.