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目的评价经皮肾镜下气压弹道联合超声碎石术处理嵌顿的输尿管上段结石的疗效。方法回顾性分析2005年6月至2008年4月采用经皮肾镜下气压弹道联合超声碎石术治疗嵌顿的输尿管上段结石81例临床资料。结果81例患者均成功建立皮肾通道,均一期单通道碎石,手术时间35～120min,结石完全清除率98.7%(80/81)。1例患者结石残留,经ESWL治疗;11例术后出现发热,给予适当的抗生素及支持性治疗;4例患者因术中出血输浓缩红细胞2U;均获治愈。随访1～9个月,无严重手术并发症。结论经皮肾镜下气压弹道联合超声碎石术用于处理嵌顿的输尿管上段结石是安全有效的方案。
Objective To evaluate the effect of percutaneous nephrolithotomy combined with ultrasonic lithotripsy on incarcerated ureteral calculi. Methods The clinical data of 81 cases of incarcerated ureteral calculi treated with percutaneous nephroscope pneumatic lithotripsy and ultrasound were analyzed retrospectively from June 2005 to April 2008. Results All the 81 patients were successfully established the renal access, the single-stage single-channel gravel operation time was 35 ~ 120min, the complete removal rate of stone was 98.7% (80/81). One patient had residual stones and was treated with ESWL. Eleven patients had fever after operation and were given proper antibiotics and supportive care. Four patients were treated with intraoperative hemorrhage to lose 2U of erythrocytes; all patients were cured. Followed up for 1 to 9 months, no serious surgical complications. Conclusion Percutaneous nephrolithotomy combined with ultrasonic lithotripsy for the treatment of incarcerated ureteral calculi is safe and effective.