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目的:评价微创经皮肾镜取石术(MPCNL)同期治疗双侧输尿管上段结石的有效性及安全性。方法:回顾性分析我院2005年10月～2009年7月共收治22例双侧输尿管上段结石患者的临床资料,全部患者均行微创经皮肾镜取石术。结果:22例患者(44例侧)一次穿刺成功,17例患者一次取净双侧结石,5例患者术后复查一侧残存肾内结石碎粒,其中4例口服排石药物,一个月后复查结石大部分排空,少量残留。1例患者于术后结合ESWL排净结石,手术结石取净率88.6%。平均手术时间(98.9±24.2)min,术中估计出血量平均(240.5±108.1)ml,术后肾造瘘管留置1～2天,术后平均住院时间(4.8±1.3)天。结论:对于身体条件良好,结石相对容易清除的双侧输尿管上段结石,同期MPCNL是安全有效的。
Objective: To evaluate the efficacy and safety of minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of bilateral ureteral calculi. Methods: A retrospective analysis of our hospital from October 2005 to July 2009 were treated 22 cases of bilateral ureteral calculi in patients with clinical data, all patients underwent minimally invasive percutaneous nephrolithotomy. Results: Twenty-two patients (44 patients) were successfully punctured at one time, and 17 patients were treated with bilateral stones at one time. Five patients were examined with residual renal calculus after operation. Among them, 4 patients were discharged with row- Most of the stones were emptying, a small amount of residual. One patient underwent ESWL with clear stones after operation, and the operation stone removal rate was 88.6%. The average operation time was 98.9 ± 24.2 min. The average blood loss during operation was 240.5 ± 108.1 ml. The postoperative nephrostomy tube was kept for 1 to 2 days and the average postoperative hospital stay was 4.8 ± 1.3 days. CONCLUSIONS: MPCNL is safe and effective over the same period for bilateral upper ureteral calculi with good body condition and relatively easy stone removal.