输尿管瘘

MPCNL to treat upper urinary lithiasis shows advantages of less blood loss, less operative trauma, and shorter postoperative recovery time.

经皮肾微造瘘输尿管镜碎石术是治疗上尿路结石的理想方法，具有损伤小、出血少、恢复快等优点。

Results Of the operation for 196 patients, intraoperative complications occurred in three patients, postoperative complications in 17, which included presacral venous hemorrhea, prostatic bleeding, ureteric injury, wound infection, anastomotic leakage, rectovaginal fistula, anastomotic stricture, fistulous necrosis and stricture, and acute urinary retention.

结果 196例直肠癌病人发生术中并发症3例(1.5%)，手术后并发症17例(8.7%)，包括骶前静脉大出血、前列腺出血、输尿管损伤、切口感染、吻合口漏、直肠阴道瘘、吻合口狭窄、急性尿潴留和造口坏死狭窄等。

Results Of the operation for 196 patients,intraoperative complications occurred in three patients,postoperative complications in 17,which included presacral venous hemorrhea,prostatic bleeding,ureteric injury,wound infection,anastomotic l...

结果196例直肠癌病人发生术中并发症3例(1.5%)，手术后并发症17例(8.7%)，包括骶前静脉大出血、前列腺出血、输尿管损伤、切口感染、吻合口漏、直肠阴道瘘、吻合口狭窄、急性尿潴留和造口坏死狭窄等。

Methods: 37 patients with complex upper urinary lithangiuria with pyonephrosis were selected during November 2002 to July 2007. 8 cases were treated with transurethral ureteroscope lithotripsy followed by tube internal drainage, while 29 cases were treated with minimally invasive percutaneous nephrolithotomy. After 714 days, minimally invasive percutaneous nephrolithotomy was employed for the second therapy.

选择2002年11月～2007年7月复杂上尿路结石合并脓肾患者37例，采用经尿道输尿管镜取石后置管内引流8例，微创经皮肾造瘘外引流29例，术后7～14 d后，2期行微创经皮肾镜治疗复杂肾结石。

Key words］ percutaneous nephrostomy;ureteroscope;urinary stones

关键词］经皮肾穿刺造瘘术；输尿管镜；尿路结石

Percutaneous nephrostomy guided by Ultrasound and C-arm mobile fluoroscopy is a safe procedure and preoperative analyzing the high risk factors of complications and preparing the preservation methods may sublimate the security and therapeutic efficacy.

熟悉肾造瘘和输尿管内双J管置入术的操作程序，术前综合评估并发症产生的危险因素，并积极防范处理，可有效提高手术安全性和治疗效果。

The ureteroscopic holmium: YAG laser lithotripsy can he the first choice for the post-renal acute renal failure associated with upper urinary tract stones, due to its safety and efficiency. At the same time, retrograde intubation under cystoscope and percutaneous nephrostomy will be helpful.

上尿路梗阻是肾后性急性肾功能衰竭的主要原因，如能明确是结石引起的肾后性肾功能衰竭，应首选输尿管镜下钬激光碎石并置管引流；如不能明确，膀胱镜下逆行插管和经皮肾穿刺造瘘引流也是可行的急诊有效方法。

The complicated ureter stone-streets were cured by trascutaˉneous nephrocentesis and nephrostomy through ureterocystoscope,haemostatic and antibiotic.The12patients hadn't variation of nephrofunction and recurrence of stone for following3-24months.

经皮肾穿刺造瘘术和输尿管镜取石，止血，抗炎等治疗后，排尽石头，随访3 月～2年未见肾功能改变和结石复发。

The complicated ureter stone-streets were cured by trascutaˉneous nephrocentesis and nephrostomy through ureterocystoscope,haemostatic and antibiotic.The12patients hadn't variation of nephrofunction and recurrence of stone for following3-24months.

经皮肾穿刺造瘘术和输尿管镜取石，止血，抗炎等治疗后，排尽石头，随访3个月～2年未见肾功能改变和结石复发。

The complications included one bladder injury, ureterovaginal fistula, intestinal injury, internal hemorrhage celiac abscess.

并发症包括膀胱损伤1例，输尿管阴道瘘1例，肠道损伤2例，内出血2例，盆腔脓肿1例。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。