Percutaneous Nephrostomy for Removal of Large Impacted Upper Ureteral Stones

對於治療上端輸尿管結石的方法目前仍有爭議，體外震波碎石以及輸尿管鏡碎石術因為較不具有侵犯性，是最目前常使用的方法；然而經皮腎造（广婁）碎石術仍然是個重要的手術方法。在2004年6月至2006年3月，共有24位患者因為上端輸尿管結石超過15公釐，並箝閉在上端輸尿管而接受經皮腎造（广婁）碎石手術處理。手術時使用合併超音波與氣動式碎石的震波頭來震碎結石。在24位患者中，有23位(95.80/0)結石完全清除，平均手術時間為124.5±49.5分鐘，範圍從45分鐘到170分鐘；平均手術後住院日為4.7±2.0天，範圍從4天到12天。術後有六位患者有短暫發燒現象，利用抗生素以及支持性療法即可處理；兩位患者發生術中出血並需輸血的併發症。我們建議利用經皮腎造（广婁）碎石術來治療大而箝閉在上端輸尿管的結石是一個安全而有效的方法。

關鍵字

經皮腎造（广婁）管；輸尿管結石；輸尿管碎石

並列摘要

The treatment for patients with large impacted proximal ureteral stone remains controversial. Extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy are the most popular treatment options due to their minimal invasive nature. However, percutaneous nephroscopic ureterolithotripsy is still important. Between June 2004 and March 2006, a total of 24 patients underwent percutaneous antegrade nephrostomy for the removal of large impacted proximal ureteral stones of size＞15 mm. Combined ultrasonic and pneumatic lithotripters were used for the stone fragmentation. Twenty-three (95.8%) of the 24 patients were stone-free after one session of surgery. The mean operation time was 125.4±49.5 minutes (range, 45-170 minutes) and the mean postoperative hospital stay was 4.7±2.0 days (range, 4-12 days). Among the 24 patients, six experienced transient postoperative fever that could be controlled with appropriate antibiotics and supportive treatment, and two had blood loss requiring blood transfusion. We suggest that percutaneous nephroscopic ureterolithotripsy is a safe and efficient treatment option for the removal of large impacted proximal ureteral stones.

並列關鍵字

percutaneous nephroscopy ； ureteral stone ； ureterolithotripsy

國際替代計量

Percutaneous Nephrostomy for Removal of Large Impacted Upper Ureteral Stones

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