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目的探讨经皮肾镜联用输尿管镜气压弹道碎石联合超声碎石术治疗输尿管上段结石的方法和疗效。方法应用EMS第三代气压弹道/超声碎石清石系统,应用微创经皮肾穿刺术治疗输尿管上段结石37例。结果37例患者中,34例一期取净结石;1例合并肾积脓,经皮肾造瘘术后二期取净结石;2例肾内有结石残留,经体外冲击波碎石治愈。一期结石清除率91.9%(34/37)。平均手术时间70 min,平均住院8.0天。术中、术后均未出现严重并发症。结论经皮肾镜联用输尿管镜气压弹道联合超声碎石清石术疗效好、创伤小,可作为治疗输尿管上段结石的一种常用方法。
Objective To investigate the method and efficacy of percutaneous nephrolithotomy combined with ureteroscopic pneumatic lithotripsy and ultrasonic lithotripsy in the treatment of upper ureteral calculi. Methods 37 cases of upper ureteral calculi were treated by minimally invasive percutaneous nephrostomy with EMS third generation pneumatic lithotripsy / ultrasonography lithotripsy. Results Among the 37 patients, 34 cases were treated with nephrolithiasis in one phase, nephrolithiasis in one case and nephrolithotomy in two cases after nephrostomy. Two cases of residual nephrolithiasis were cured by extracorporeal shock wave lithotripsy. A stone clearance rate of 91.9% (34/37). The average operation time was 70 min and the average hospitalization was 8.0 days. Intraoperative and postoperative no serious complications. Conclusion Percutaneous nephrolithotomy with ureteroscopic pneumatic ballistics combined with ultrasonic lithotripsy is effective and less traumatic. It can be used as a common method for the treatment of upper ureteral calculi.