论文部分内容阅读
目的探讨经第11肋间入路经皮肾取石术(minpercutaneous nephrolithotomy,MPCNL治疗嵌顿性输尿管上段结石的疗效和安全性。方法 2002年6月至2007年11月,对375例嵌顿性输尿管上段结石采用第11肋间入路的MPCNL治疗。穿刺点选择在第11肋间腋后线内侧3 cm的范围内或第12肋尖外上方,常规穿刺后组肾脏中盏建立手术通道,行钬激光或气压弹道碎石。结果373例手术获得成功(99.5%),2例因通道迷失而失败。平均手术时间(35±12)min。无大出血、胸膜损伤及其他严重并发症。一次手术后的结石清除率为98.7%。术后2～4周复查,无1例结石残留。结论经第11肋间入路的MPCNL是治疗嵌顿性输尿管上段结石的有效手段之一。选择第11肋间腋后线内侧3 cm范围内或第12肋尖外上方可避免胸膜损伤。
Objective To investigate the efficacy and safety of the 11th intercostal percutaneous nephrolithotomy (MPCNL) in the treatment of incarcerated ureteral calculi.Methods From June 2002 to November 2007, 375 cases of incarcerated ureter The upper stones were treated with MPCNL using the 11th intercostal approach.The puncture points were selected within the range of 3 cm inside the 11th intercostal axillary line or above the 12th ribbed edge and the surgical puncture was established in the middle of the renal puncture group after routine puncture Holmium laser or pneumatic lithotripsy were performed.Results 373 operations were successful (99.5%) and 2 patients lost due to channel loss.The average operation time was (35 ± 12) min.There was no major bleeding, pleural injury and other serious complications.One operation The stone removal rate was 98.7% .After 2 to 4 weeks of review, there was no residual stone in one case.Conclusion The 11th intercostal MPCNL is an effective method for the treatment of upper ureteral calculi.Selecting the 11th Intercostal axillary line medial 3 cm range or beyond the top of the 12th rib to avoid pleural damage.