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目的总结经皮肾微造瘘输尿管镜碎石、取石术(PCNL)联合肾舒冲剂治疗肾、输尿管上段结石的临床价值。方法在B超引导下经皮肾穿刺造瘘,将通道扩张至F14-18,从造瘘通道插入输尿管镜到结石处,用气压弹道碎石机将结石击碎,取出碎石片。术后口服肾舒冲剂,促进排石、消炎和肾功能恢复。结果42例患者,27例一期取净结石,8例1周后二期取净结石,7例肾盏内有小块结石残留,经体外震波碎石(ESWL)或软性膀胱镜取石后治愈。结论经皮肾微造瘘碎石、取石术疗效佳,损伤小,安全性较高,可作为治疗肾、输尿管上段复杂结石的重要方法,若与ESWL结合疗效更佳。术后应用肾舒冲剂促进消炎、利尿、排石,有助于患者的康复。
Objective To summarize the clinical value of percutaneous nephrostomy combined with ureteroscopic lithotripsy and lithotripsy (PCNL) and Shen Shu granules in the treatment of renal and upper ureteral calculi. Methods Percutaneous nephrostomy was performed under B-guided ultrasonography. The channel was expanded to F14-18. The ureteroscope was inserted into the calculus from the fistula channel. The calculus was crushed by pneumatic lithotripsy and the crushed stone was removed. Postoperative oral Shen Shu granules to promote row of stone, anti-inflammatory and renal function recovery. Results Twenty-four patients, 27 cases of primary neoplasm, 8 cases of secondary neoplasm after one week, 7 cases of residual calculus in calyces, extracorporeal shock wave lithotripsy (ESWL) or soft cystoscopy cure. Conclusion Percutaneous nephrostomy lithotripsy and lithotomy are effective, less damaging and more safe. They can be used as an important method for treating complex stones in the upper ureter and upper ureter. If combined with ESWL, the curative effect is better. After the application of Shen Shu granules to promote anti-inflammatory, diuretic, Pai Shi, help patients rehabilitation.