单通道双导管套鞘法经皮肾镜碎石术治疗复杂性输尿管中上段结石的疗效观察

Percutaneous nephrolithotomy (PCNL) with the single channel double sets of catheter sheath method in the management of complicated ureteric calculus

摘要:

目的 评估单通道双导管套鞘法经皮肾镜碎石术（PCNL）治疗复杂性输尿管中上段结石的疗效 及安全性。方法 回顾性分析48 例复杂性输尿管中上段结石患者的临床资料，其中18 例合并同侧肾结石，1 例合并重复肾畸形，结石位于上位肾的输尿管内。结果 48 例患者在B 超引导下顺利穿刺建立经皮肾通道， 建立通道后置入双套鞘确定肾盂输尿管连接部时间为（18.0±5.0）min，手术时间为（59.0±6.0）min，结石 清除率为96.6% ；无感染性休克、大出血和周围脏器损伤等严重并发症，术后对患者随访3 ～ 6 个月，肾积 水程度明显减轻，未出现输尿管狭窄病变。结论 对于复杂性输尿管中上段结石患者，单通道双导管套鞘法 PCNL 是一种安全有效的治疗方法。

Abstract:

Objective To evaluate the effect of the percutaneous nephrolithotomy (PCNL) with the single channel double sets of catheter sheath method in the management of complicated ureteric calculus. Methods The clinical data of forty-eight cases with complicated ureteric calculus were retrospectively investigated. Among them, 18 cases with ipsilateral kidney calculus, 1 case with repeat renal deformity, within the ureteral calculus in upper kidney. Results 48 patients smoothly under ulime from ultrasound guided puncture percutaneous renal channel is established successfully, The establishing the channel to setting the double sheath to the ureteropelvic junction was (18.0 ± 5.0) min, the operation time was (59.0 ± 6.0) min, the stone free rate was 96.6% and no significant complications, such as septic shock, intraoperative or postoperative bleeding and damage to surrounding organs, were detected. The patients were followed up for 3 to 6 months, the degree of hydronephrosis significantly reduced and no ureteral stricture were developed during the period. Conclusion The percutaneous nephrolithotomy (PCNL) with the single channel double sets of catheter sheath method is safe and effective for complicated ureteral calculus.