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目的:观察经皮肾镜取石术并同期冷刀内切开治疗肾盂输尿管连接部梗阻(UPJO)患者的疗效。方法:2011年3月~2014年10月采用经皮肾镜取石术并同期冷刀内切开治疗UPJO患者19例,并观察其手术时间、术后并发症、住院时间、术后患者腰痛等临床症状是否缓解及肾积水是否消失等情况。结果:19例患者平均手术时间96(50~145)min,术后平均住院时间8.4(5~11)d;围手术期并发症4例(21.1%),术后双J管相关并发症2例(10.5%)。随访1~43个月,平均12个月,手术成功率84.2%(16/19)。3例手术失败者行二次开放手术干预,其中2例发现异位血管存在,1例术中发现周围瘢痕粘连严重。结论:经皮肾镜取石术并同期冷刀内切开治疗UPJO合并肾结石患者是一种安全、可靠、有效的治疗方法,可作为首选的手术方式。
Objective: To observe the effect of percutaneous nephrolithotomy and cold knife incision in the treatment of ureteropelvic junction obstruction (UPJO). Methods: From March 2011 to October 2014, 19 patients with UPJO were treated with percutaneous nephrolithotomy and cold knife incision. The operative time, postoperative complications, length of stay, and postoperative patients with back pain were observed Whether clinical symptoms and hydronephrosis disappear and so on. Results: The average operation time was 96 (50 ~ 145) min in 19 patients and average postoperative hospital stay was 8.4 (5 ~ 11) days. Perioperative complications occurred in 4 patients (21.1%), postoperative double J tube related complications Example (10.5%). The patients were followed up for 1 to 43 months, with an average of 12 months. The successful rate of operation was 84.2% (16/19). Three patients with failed operation underwent second open surgery intervention, two of them found ectopic blood vessels, and one was found to have severe scarring around the operation. Conclusion: Percutaneous nephrolithotomy combined with cold knife incision in the treatment of patients with UPJO and renal stones is a safe, reliable and effective treatment, which can be used as the preferred surgical approach.