【摘要】 目的分析上尿路结石的各种手术方式,探讨临床治疗中合理的术式选择。方法回顾性分析1997年-2004年收治的2 528例上尿路结石患者的临床分类、手术方式及并发症。结果单纯性肾结石和输尿管上段结石以ESWL治疗为主,3个月内结石排净率为86%,5%形成石街,9%经2-3次ESWL治疗无排石现象,转手术率14%;中、下段结石采用输尿管镜下气压弹道碎石治疗为主,结石排净率为92%。经皮肾穿肾镜取石,肾盂和输尿管上段结石的取净率为100%;鹿角形结石的取净率为95%;复杂性肾结石选择开放性手术取石或联合方式治疗为主,因肾脏无功能而行一侧肾切除7例(1.6%),手术后输尿管漏7例,切口经久不愈3例,肾脏大出血5例,无死亡病例。结论上尿路结石的微创手术可以避免开放手术对患者造成的痛苦,减少术后并发症,但也不能盲目采用,对于复杂性结石,开放手术仍有实际应用价值。更多还原

【Abstract】 Objective To compare the various treatments of upper urinary tract calculi.Methods The data of 2528 patients with upper urinary tract calculi during 1997 to 2004 were analyzed retrospectively.Results Patients with simple kidney stone and upper ureteral stone were mainly treated with ESWL.The stone-free rate of ESWL was 86%;5% patients formed stone street,and 9% showed no effects after 2-3 times of ESWL;14% had to use other methods.Patients with middle or lower ureteral stone were mainly treated with ballistic lithotripsy,and the stone-free rate was 92%.The stone-free rate of PCNL was 100% for pelvic and upper ureteral stone and 95% for stag-horn stone.Patients with complicated kidney stone were mainly treated with open surgery or combination of procedures.After operation,7 cases underment nephrectomy of oneside because dysfunction;7 developed leakage of urine,3 chronic difficult-to-heal wounds;5 hemorrhages in kidney,and no one died.Conclusion The micro-invasive surgery to remove upper urinary tract calculi can avoid pain in patients,and decrease the difficulty of operation and perioperative complications.But the open surgery is still of great use for complicated stone.In all these methods,inflammation and functional lesion should be controlled carefully.更多还原