双侧上尿路结石同期行双肾微创经皮肾镜碎石取石术125例.docVIP

双侧上尿路结石同期行双肾微创经皮肾镜碎石取石术125例 　　摘要：目的 对125例患有双侧上尿路结石患者进行同期经皮肾镜取石术（MPCNL），研究其治疗效果。方法 以2014年7月～2015年7月于我院接受术前肾穿刺造瘘引流的双侧同期微创经皮肾镜取石术125例患者为研究对象，包括45例双肾结石患者，34例肾结石合并一侧感染患者或双侧输尿管近端结石患者，46例双侧输尿管结石患者，0.8×1.3≤结石直径（cm）≤3.4×4.3。结果 研究对象中仅有5例转为分期手术，其余正常，结石一期清除率和总清除率分别为0.752、0.84。结论 针对双侧上泌尿道结石患者，先行肾穿刺造瘘并进行引流，再行双侧微创同期经皮肾镜取石术，但该术不适于双肾结石结石过大患者。 　　关键词：同期；双侧结石；经皮肾镜；上尿路 　　Clinical Analysis of 125 Cases of Bilateral Upper Urinary Calculi with Minimally Invasive Percutaneous Lithotripsy 　　WANG Yong 　　（Department of Urology Surgery，The first peoples Hospital of Ziyang，Ziyang 641300，Sichuan，China） 　　Abstract：Objective Analysis of surgery double kidney minimally invasive percutaneous nephrolithotomy on 125 bilateral upper urinary tract stone patients.Methods Choose 125 case of patients as the object who accept the surgery renal biopsy ostomy drainage preoperative and double kidney minimally invasive percutaneous nephrolithotomy during July 2014 to July 2015 in our hospital，including 45 case of double kidney stones patients，34 case of kidney stones merge one or both upper ureteral calculi patients and 46 case of patients with bilateral ureteral calculi.Results Only five patients were taken into staging surgery，the rest were normal.The clearance and total clearance rates of first period of stone were 75.2%and 84%.Conclusion For the bilateral urinary tract stones，the surgery renal biopsy ostomy drainage preoperative and double kidney minimally invasive percutaneous nephrolithotomy were effective，but double kidney stones patients. 　　Key words：Same period；Bilateral stones；Percutaneous nephrolithotomy；Upper urinary tract 　　输尿管镜、肾镜术在我国有了不断的提高，现今的微创腔镜术取代了以前的开放性手术。经皮肾镜取石术治疗尿结石有很好的临床疗效，且安全、可靠，术后恢复快。 　　1资料与方法 　　1.1一般资料 研究对象计125例，男性75例，女性50例，患者年龄在18～69岁。包括45例双肾结石患者，34例肾结石合并一侧感染患者或双侧输尿管上段结石患者，46例双侧输尿管结石患者，KUB测量得到，0.8×1.3≤结石直径（cm）≤3.4×4.3。有35例患者采取过ESWL治疗，不见疗效，有12例患者进行过传统取石治疗。有52例肾功能不全患者，在行肾穿刺造瘘置管引流后有37例恢复正常，ARF患者15例。125例研究对象均未出现全身性出血性疾病。术前行超声、KUB+IVU检查。合并高血压或冠心病22例，糖尿病18例，采取药物治疗。 　　1.2方法 积极术