论文部分内容阅读
目的探讨微造瘘经皮肾镜取石术(minimally invasive percutaneous nephrolithotomy,MPCNL)治疗双侧上尿路结石的疗效及安全性。方法 2006年10月至2009年6月采取MPCNL治疗双侧肾及输尿管上段结石68例。双肾结石42例,一侧肾结石合并对侧输尿管上段结石26例。结果①对32例肾或输尿管上段结石患者(结石为单发,且直径<2.5cm)实施一期双侧MPCNL,其中双肾结石18例、一侧肾结石合并对侧输尿管上段结石14例。手术时间68～124分钟,平均100分钟。肾结石清除率为88%(44/50),输尿管上段结石为93%(13/14)。②对36例复杂性肾结石患者(结石直径>2.5cm或多发结石)采取分期手术。该组双侧肾结石24例,一侧肾结石合并对侧输尿管上段结石12例。一期行单侧MPCNL 4例,双侧32例,手术时间97～150分钟,平均118分钟;二期行单侧MPCNL 11例,双侧25例。肾结石清除率为68%(41/60),输尿管上段结石为92%(11/12)。结论对双侧。肾及输尿管上段结石患者,如结石为单发,且直径<2.5cm,可行一期双侧MPCNL治疗;如肾结石直径>2.5cm或为多发结石,应分期手术以防严重并发症的发生。
Objective To investigate the efficacy and safety of minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of bilateral upper urinary calculi. Methods From October 2006 to June 2009, 68 cases of bilateral renal and upper ureteral calculi were treated with MPCNL. 42 cases of kidney stones, kidney stones on the side of the contralateral ureteral stones in 26 cases. Results ① A total of 32 patients with renal or upper ureteral calculi (single stone and diameter <2.5cm) underwent bilateral MPCNL. There were 18 cases of bilateral renal calculi, 14 cases of renal calculi with contralateral ureteral calculi. Surgery time 68 to 124 minutes, an average of 100 minutes. Kidney stone clearance rate was 88% (44/50), upper ureteral stones was 93% (13/14). ② Stages were performed on 36 patients with complicated kidney stones (diameter> 2.5cm or multiple stones). The group of bilateral kidney stones in 24 cases, one side of the kidney stones with contralateral ureteral stones in 12 cases. One-sided MPCNL unilateral line in 4 cases, bilateral in 32 cases, the operation time of 97 to 150 minutes, an average of 118 minutes; two unilateral MPCNL in 11 cases, bilateral in 25 cases. Kidney stone clearance rate was 68% (41/60), upper ureteral stones was 92% (11/12). Conclusions on both sides. Kidney and upper ureteral calculi patients, such as stones as a single, and the diameter of <2.5cm, a feasible bilateral MPCNL treatment; such as kidney stones diameter> 2.5cm or multiple stones should be staged surgery to prevent the occurrence of serious complications.