摘要
目的探讨双侧上尿路结石(bilateral upper urinary calculi,BUUC)行同期微创手术治疗的安全性及疗效。方法对59例BUUC患者行同期微创手术治疗,其中15例行双侧经尿道输尿管镜钬激光碎石术(URSL),20例行一侧经皮肾镜碎石术(PCNL)及对侧URSL,18例行双侧PCNL,6例行双侧经腹入路腹腔镜取石术。结果手术均顺利完成,平均手术时间(45.0±10.0)min,清除结石平均直径(1.3±0.3)cm,平均结石量(3.5±0.8)枚,一次性结石清除率83%(49例),10例(17%)肾脏残石行药物排石清除;术后2例(3%)继发感染性休克,平均(5.5±1.5)d出院。随访至少半年,无输尿管狭窄及肾积水等继发病变,肾功明显改善。结论同期微创碎石术治疗体积小、数量少的BUUC,安全有效。
Objective To investigate the safety and efficacy of minimally invasive surgery for bilateral upper urinary calculi（bilateral,upper,urinary,calculi,BUUC） during the same period.Methods The BUUC patients underwent minimally invasive surgical treatment of 59 cases,15 cases underwent bilateral transurethral ureteroscopic holmium laser lithotripsy（URSL）,the other 20 cases underwent percutaneous nephrolithotomy（PCNL） and contralateral URSL,18 cases underwent bilateral PCNL,6 cases underwent bilateral transabdominal laparoscopic lithotomy.Results The operations were completed successfully,the average operative time（45.0±10.0） min,the mean diameter of the stones clearance（1.3±0.3） cm,the average volume of 3 stones（3.5±0.8）,onetime stone clearance rate was 83%（49 cases）,10 cases（17%） kidney stone residue for medicine row stone removal;Secondary infection shock occurred in 2 cases（3%）,and discharged on average（5.5 ± 1.5） d.At least half a year follow-up,no ureteral stenosis and hydronephrosis and other secondary lesions,kidney function improved significantly.Conclusion Minimally invasive lithotripsy at the same time is safe and effective in the treatment of small volume and small amount of BUUC.
出处
《中国继续医学教育》
2017年第20期90-92,共3页
China Continuing Medical Education
关键词
双侧上尿路结石
微创手术
同期碎石
bilateral upper urinary calculi
minimally invasive surgery
concurrent lithotripsy
