Minimally invasive percutaneous nephrostomy in stage Ⅰ and ureteroscopic lithotomy combined with percutaneous nephrolithotomy in stage Ⅱ for the treatment of complicated ureteral calculi steps(Report of 27 cases)
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摘要: 目的：探讨复杂性输尿管石街在临床上有效的微创治疗方法。方法：采用Ⅰ期肾穿刺微造瘘Ⅱ期双镜（输尿管镜碎石+经皮肾镜碎石取石）联合治疗27例复杂性输尿管石街。结果：Ⅰ期B超定位下100%成功完成肾穿刺微造瘘，Ⅱ期双镜联合一次性治疗输尿管石街并肾内结石，清石率92.59%，无术中、术后大出血，无发热及其他重大并发症发生。结论：复杂性输尿管石街发生时多伴有患侧多发性肾结石并明显的肾积水、感染发生和肾功能损害，采用Ⅰ期肾穿刺微造瘘Ⅱ期双镜联合的方式进行治疗术前可有效的判断患肾功能，明显减少术中、术后感染、出血的发生，提高手术安全性和清石率。Abstract: Objective: To evaluate the clinical effect of minimally invasive treatment method for the treatment of complicated ureteral calculi steps.Method: Minimally invasive percutaneous nephrostomy in stage Ⅰ and ureteroscopic lithotomy combined with percutaneous nephrolithotomy in stage Ⅱ (URL combined with PCNL in stage Ⅱ) were used for the treatment of 27 cases of complicated ureteral calculi steps. Result: Under ultrasonic guidance all minimally invasive percutaneous nephrostomy were successfully established in stage Ⅰ, in stage Ⅱ URL combined with PCNL were used for the treatment of complicated ureteral calculi steps and renal calculi, a 92.59% stone-free rate was achieved, no serious complications such as haemorrhage, infection and fever were observed in intraoperative and postoperative. Conclusion: Complicated ureteral calculi steps always take place with multiple renal calculi and hydronephrosis, infection and renal damage. Using the way of minimally invasive percutaneous nephrostomy in stage Ⅰ and URL combined with PCNL in stage Ⅱ for the treatment may judge the renal function in pre-operation, decrease the incidence rate of fever and haemorrhage in intraoperative and postoperative, increase the total calculi clearance rate and improve the success rate of surgery at last.
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