目的 探讨输尿管软镜联合物理振动排石治疗大体积上尿路结石的临床价值.方法 回顾性分析2016年2月-2017年3月在该中心行输尿管软镜联合物理振动排石治疗的62例大体积上尿路结石患者的临床资料,平均结石负荷为(656.70±275.40)mm2.观察结石的清除率,术中的一般情况,术后的不良反应及术后肾功能变化等情况.结果 62例患者均顺利完成输尿管软镜手术,1周后行物理振动排石治疗,次日结石排净率为61.29％(38/62),1周后排净率为85.48％(53/62),3周后排净率为96.77％(60/62).其中2例出现术后发热,总并发症3.23％.18例术后肾功能好转,4例术后肾功能保持稳定.结论 输尿管软镜联合物理振动排石治疗大体积上尿路结石清石率高,并发症少,对肾功能影响小,是一种安全有效的治疗方法,值得在临床推广应用.%Objective To evaluate the clinical efficacy of flexible ureteroscopy combined with physical vibration lithecbole in treatment of massive upper urinary calculi. Methods The clinical data of 62 cases with massive upper urinary calculi from Feb 2016 to Mar 2017 were analyzed retrospectively. The average diameter of stones were (656.70 ± 275.40) mm2. The removal rate of stones, general conditions during the operation, the postoperative adverse reactions and renal function changes were observed. Results All 62 patients had successfully completed flexible ureteroscopy operation, and had physical vibration stone removal treatment after 1 week. The rate of stone removal was 61.29％ in the next day (38/62), 85.48％ (53/62) in the next 1 week and 96.77％ (60/62) in the next 3 weeks. Postoperative fever occurred in 2 cases, the overall complication rate was 3.23％. 18 patients had improved renal function while 4 patients keep stable after operation. Conclusion The flexible ureteroscopy combined with physical vibration lithecbole is a safe and effective therapeutic method for massive upper urinary calculi. It has high stone removal rate, less complications, little impact on renal function. It is valuable to advocate clinically.
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