Aim To investigate the clinical application value and method of ultrasound-guided minimally invasive percutaneous nephro-lithotomy(MPCNL)in the treatment of upper ureteral calculi.Methods Twenty-one patients with upper ureteral calculi received mini-really invasive percutaneous renal puncture and ureteroscopic lithotripsy under the guidance of ultrasound.Twelve male,9 female,Mean patient age was 45.6 years(18～57 years).The calculi located in the left upper ureter were 11 cases,10 in the right.Combined with ip-silateral renal calculus were in 8 cases,one patient associated with ureteral stricture,intermediate hydrops in 9 cases,severe hydrops in 6 cases.Mean stone size was 16 mm(10～30 mm)in diameter.Results All the patients were punctured successfully at one prick and twenty patients with upper ureteral calculi were removed out through single passage in phrase I.Operative duration was 60～150 min.The total stone clearance rate was 95.2%.Residual stone fragment was found in 1 patient.Then discharged one week later after pull out D-J tube.No serious complications occurred in the operation.Conclusion Ultrasound-guided minimally invasive percutaneous nephrolithoto-my is a safe and effective technique for the treatment of upper ureteral calculi or associated with ipsilateral renal calculus or ureteral stric-ture with the advantages of little trauma and rapid recovery.Meanwhile,ipsilateral renal calculus and ureteral stricture can also be trea-ted effectively.%目的 探讨微创经皮肾镜取石术(MPCNL)治疗输尿管上段结石的方法及效果.方法在超声引导下对21例输尿管上段结石患者行经皮肾穿刺建立碎石微通道,经通道于输尿管镜下行碎石取石术.其中男性12例,女性9例,年龄18～57岁,平均年龄45.6岁.左侧输尿管上段结石11例,右侧10例.8例合并同侧肾脏结石.1例合并输尿管狭窄,肾脏中度积水15例,重度积水6例.结石1.0～3.0 cm大小不等.结果21例均成功建立经皮肾镜微创通道,一期单通道碎石,手术时间60～150 min,20例一期结石完全清除,清除率95.2%,1例结石残留,后自行排出.未出现严重并发症.结论微创PCNL治疗输尿管上段结石或合并肾结石及输尿管上段狭窄安全、有效,具有创伤小,恢复快等优势.同时可以有效清除肾结石,对输尿管上段狭窄可同期行内切开术.
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