CAJ | 학술논문

目的：探讨斜仰卧截石位经皮肾镜联合输尿管镜处理输尿管上段复杂结石的安全性及有效性。方法2009年1月～2012年10月，采取斜仰卧截石位经皮肾镜联合输尿管镜治疗输尿管上段复杂结石67例，气管插管全麻，先行经皮肾镜处理结石，向下移位结石再行输尿管镜将移位结石碎石并经工作通道冲出。结果67例手术均一次完成，手术时间46～106 min，平均76 min。一次结石清除率92．5％（62/67），结石残留5例，配合ESWL 2周后结石完全清除。均无大出血、输尿管撕脱、脏器损伤等并发症。结论斜仰卧截石位经皮肾镜联合输尿管镜处理输尿管上段复杂结石具有体位舒适，避免术中体位变换带来的不便，手术时间短，有利于术中麻醉监护，碎石取石效果好，并发症少的优点，治疗的安全性高，值得临床推广。
목적：탐토사앙와절석위경피신경연합수뇨관경처리수뇨관상단복잡결석적안전성급유효성。방법2009년1월～2012년10월，채취사앙와절석위경피신경연합수뇨관경치료수뇨관상단복잡결석67례，기관삽관전마，선행경피신경처리결석，향하이위결석재행수뇨관경장이위결석쇄석병경공작통도충출。결과67례수술균일차완성，수술시간46～106 min，평균76 min。일차결석청제솔92．5％（62/67），결석잔류5례，배합ESWL 2주후결석완전청제。균무대출혈、수뇨관시탈、장기손상등병발증。결론사앙와절석위경피신경연합수뇨관경처리수뇨관상단복잡결석구유체위서괄，피면술중체위변환대래적불편，수술시간단，유리우술중마취감호，쇄석취석효과호，병발증소적우점，치료적안전성고，치득림상추엄。
Objective To investigate the safety and efficacy of percutaneous nephrolithotomy ( PCNL ) combined with ureteroscopy in supine anterolateral lithotomy position for the management of complicated upper ureteric calculi . Methods From January 2009 to October 2012, 67 patients underwent PCNL combined with ureteroscopy in supine position under general anesthesia . Renal calculi was treated with PCNL , and then ureteroscopy was used to break and wash out the residual calculi . Results All the 67 surgeries were completed successfully .Operation time was 46 -106 min ( average, 76 min); stone clearance rate was 92.5%(62/67);residual stone was found in 5 cases and were completely removed two weeks after ESWL .No massive hemorrhage , ureteral avulsion, pleura, abdominal organ injury or other complications occurred . Conclusions PCNL combined with ureteroscopy in supine anterolateral lithotomy position for the treatment of complicated upper ureteric calculi is safe and effective .It has shorter operative time and is convenient for the patients .