摘要
目的 :探讨上尿路结石的现代治疗方法。方法 :回顾性分析 2 0 0 1年 2月 8日～ 2 0 0 2年 12月 31日收治的 5 178例上尿路结石患者的临床资料。结果 :5 178例中 ,采用体外冲击波碎石术 (ESWL)治疗 182 6例 ,输尿管镜取石术 (URL) 2 15 7例 ,微创经皮肾镜取石术 (mini PCNL) 1131例 ,腹腔镜输尿管切开取石术 8例和开放手术 5 6例 ,分别占总数的 35 .3%、4 1.7%、2 1.8%、0 .2 %和 1.0 %。ESWL治疗中 ,1个月后结石排净率为 83.0 % ,2个月后结石排净率为 86 .0 % ,3个月后为 86 .5 %。术后有 13例发生输尿管石街 ,采用URL或PCNL取净。URL对输尿管中、下段结石取净率为 10 0 % ,上段为 76 % ,术中无输尿管穿孔和撕脱并发症发生。mini PCNL对肾盂和输尿管上段结石的取净率为 10 0 % ,鹿角形结石为 93%。术中未见肾盂大穿孔和肾皮质撕裂。术后 79例输血 ,输血率为 1.5 %。腹腔镜治疗 8例全部成功 ,无并发症发生。结论 :上尿路结石可用腔内技术和ESWL治疗 ,开放手术几乎可避免。
Purpose:To investigate the current situation of treating upper urinary tract calculi.Method:The information of 5178 cases of upper urinary tract calculi which were treated by extracorporeal shock wave lithotripsy(ESWL), ureteroscopic lithotripsy(URL), mini-percutaneous nephrolithotomy(mini-PCNL) , laparoscopic ureterolithotomy and open surgery was analysed.Result:Of 5178 cases, 1826 cases were treated by ESWL, 2157cases by URL, 1131cases by mini-PCNL, 8 cases by laparoscopic ureterolithtomy, only 56 cases by open surgery, respectively 35.3 41.7 21.8 0.2and 1.0proportionate to total number. The stone-free rate of ESWL was 83% at 1 month, 86% at 2 months and 86.5at 3 months respectively. There were 13 steinstrasses after ESWL, and were rendered stone free with URL or mini-PCNL. The stone-free rate of URL was 100% for middle and lower ureteral stone, 76% for upper ureteral stone,respectively. There was no ureter perforation and avulsion happened. The stone-free rate of mini-PCNL was 100% for pelvic and upper ureteral stone, 93% for stag-horn stone respectively. And there was no big pelvic perforation and parenchyma laceration recorded, 79 cases required transfusions, and the transfusion rate was 1.5. All laparoscopic ureterolithotomies were success, and no complications happened.Conclusion:Upper urinary tract calculi can be managed by endourologic technique and ESWL, and open surgery is almost avoidable.
出处
《临床泌尿外科杂志》
2004年第6期325-327,共3页
Journal of Clinical Urology
关键词
尿路结石
碎石术
输尿管镜取石术
微创经皮肾穿刺取石术
腹腔镜输尿管切开取石术
Upper urinary tract calculi
Extracorporeal shock wave lithotripsy
Ureteroscopic lithotripsy
mini-Percutaneous nephrolithotomy
Laparoscope
