目的 探讨经皮顺行输尿管软镜处理输尿管中下段结石的安全性和有效性.方法 输尿管结石患者11例,先取截石位行输尿管镜取石术,均因输尿管镜未能抵达结石处导致手术失败中转经皮顺行输尿管软镜碎石术.结果 11例患者均成功完成顺行输尿管软镜碎石手术,手术时间70~160min,平均115min.术后3~5d行腹部X线平片或CT检查均未见结石残留,术后5~7d拔除肾造瘘管.无胸膜及周围脏器损伤,无输尿管穿孔,术后无大出血及严重感染患者.术后随访6~12个月未发现输尿管狭窄.结论 经皮顺行输尿管软镜碎石安全、有效,值得在有条件的单位推广应用.%Objective To investigate the efficacy and safety of anterograde flexible ureteroscopy lithotomy in the management of middle-lower ureteral calculi. Methods 11 patients with stones in middle or lower segments were failed by treating with retrograde ureteroscopy lithotomy at first,then we used anterograde flexible ureteroscopy lithotomy. Results All of 11 surgeries were successful. The operation time was 70-160 min,average time was 115 min. In 3 to 5 days after surgery,checked up by X-ray or CT,no residual stone was found in the ureter. No severe complication occurred in all patients,such as pleural injury,ureteral perforation,hemorrhage or severe infection. Nephrostomy tube was removed in 5-7days. In 6 to 12 months follow-up after surgery,no ureteral stricture was observed. Conclusion Anterograde flexible ureteroscopy lithotomy is an effective and safe treatment.
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