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目的探讨经尿道输尿管镜治疗梗阻性脓肾的临床应用。方法从2008年6月～2010年8月收治上尿路结石梗阻性脓肾患者17例,经尿道输尿管镜下气压弹道碎石取石术。结果 16例输尿管中上段结石患者1次碎石、取石成功。1例输尿管上段结石患者术中碎石过程中碎石块冲回肾内,2周后经体外冲击波碎石后结石排出。17例患者手术时间28～120min,平均46min。17例患者术后1～3d体温降至正常,腰痛症状消失。术后4～8周拔出双J管。随访3～12个月,IVP提示患肾积水均有减轻。结论结石梗阻性脓肾的患者应用输尿管镜技术具有同时处理输尿管结石,解除梗阻,充分引流脓液,以及使用敏感抗生素,提高保肾率。具有疗效好、损伤小、安全可靠、恢复快等优点,值得临床推广应用。
Objective To investigate the clinical application of transurethral ureteroscopy in the treatment of obstructive pus. Methods From June 2008 to August 2010, 17 patients with upper urinary tract obstructive pus were treated by transurethral ureteroscopic pneumatic lithotripsy. Results 16 cases of upper ureteral calculi in patients with stone, stone success. One case of upper ureteral calculi in patients with lithotripsy lithotripsy back into the kidney, 2 weeks after extracorporeal shock wave lithotripsy stone discharge. The operation time of 17 patients was 28 ~ 120min with an average of 46min. 17 cases of patients after 1 ~ 3d body temperature dropped to normal, low back pain symptoms disappear. After 4 to 8 weeks pull out double J tube. Follow-up 3 to 12 months, IVP prompted hydronephrosis have reduced. Conclusion Ureteroscopy in patients with obstructive pyonephrosis of stones should be treated simultaneously with ureteral calculi to relieve obstruction, drainage of pus, and the use of sensitive antibiotics to improve the retention rate. Has a good effect, less damage, safe, reliable, fast recovery, etc., it is worthy of clinical promotion and application.