CAJ | 학술논문

目的：探讨经皮肾镜一期治疗继发性上尿路狭窄合并肾结石的可行性与临床疗效。方法回顾分析我院2006年7月～2013年7月97例继发性上尿路狭窄合并肾结石的临床资料。建立F24标准经皮肾镜操作通道，超声联合气压弹道将结石击碎并吸出体外，应用自制电钩或钬激光直视下将狭窄段切开。放置F5双J管2枚内引流。结果93例一期手术成功，手术时间30～180 min，平均75 min。1例因输尿管管腔完全闭塞，改开放手术；2例穿刺出脓性尿液，肾镜下碎石取石后，放置肾造瘘，二期内切开术；1例碎石时间较长，改二期内切开术。93例一期手术成功者术后随访3个月～3年，平均12个月。治愈84例，有效6例，无效3例。结论经皮肾镜一期治疗继发性上尿路狭窄合并肾结石，临床效果较好，手术创伤较小，术后恢复好、快，安全，具有可重复性的优点。
목적：탐토경피신경일기치료계발성상뇨로협착합병신결석적가행성여림상료효。방법회고분석아원2006년7월～2013년7월97례계발성상뇨로협착합병신결석적림상자료。건립F24표준경피신경조작통도，초성연합기압탄도장결석격쇄병흡출체외，응용자제전구혹화격광직시하장협착단절개。방치F5쌍J관2매내인류。결과93례일기수술성공，수술시간30～180 min，평균75 min。1례인수뇨관관강완전폐새，개개방수술；2례천자출농성뇨액，신경하쇄석취석후，방치신조루，이기내절개술；1례쇄석시간교장，개이기내절개술。93례일기수술성공자술후수방3개월～3년，평균12개월。치유84례，유효6례，무효3례。결론경피신경일기치료계발성상뇨로협착합병신결석，림상효과교호，수술창상교소，술후회복호、쾌，안전，구유가중복성적우점。
Objective To investigate the feasibility and the efficacy of one-stage percutaneous nephroscopy in the treatment of secondary upper urinary stricture combined with renal calculi. Methods A retrospective analysis was carried out on clinical data of 97 patients with secondary upper urinary stricture complicated with renal calculi from July 2006 to July 2013. Percutaneous nephroscopy was performed through the F24 standard approach.The renal stones were broken and sucked out by the combination of pneumatic and ultrasonic measures.The ureterostenosis segment was opened by using endoscopic incision with monopolar or holmium laser.Two F5 D-J stent were placed after the operation. Results The operation was successfully accomplished in one session in 93 patients.The operation time ranged from 30 to 180 min, with a mean of 75 min.Conversion to open surgery was required in 1 patient because of complete ureteral occlusion.Two patients with renal stones were accompanied with pyonephrosis, and after a renal cannula was indwelled after stone breaking, a second endoscopic operation was performed.One patient experienced a long operation time, and then cured by a secondary endoscopic surgery.Postoperative follow-up for 3 months to 3 years ( mean, 12 months) in the 93 cases of one-stage percutaneous nephroscopy showed 84 cases of cure, 6 cases of effective outcomes, and 3 cases of ineffective results. Conclusion Percutaneous nephroscopy in one session for the treatment of secondary upper urinary stricture combined with renal calculi is effective, minimally invasive, safe, and repeatable.