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目的：探讨经皮肾镜取石术（PCNL）对嵌顿性输尿管上段结石的治疗效果及临床应用推广价值。方法回顾性分析187例嵌顿性输尿管上段结石患者应用PCNL手术方法治疗的临床资料，男112例，女75例，年龄17～75岁，平均49岁。病程2个月～8年，平均13个月。结石大小为1.2cm×0.8cm～3.4cm×3.2cm，平均1.8cm×1.2cm。单侧嵌顿性输尿管结石138例，双侧49例，其中合并同侧肾结石56例，孤立肾嵌顿性输尿管结石13例，肾功能不全37例，有过同侧输尿管切开取石病史43例，输尿管镜碎石失败86例。结石位置最低达第4腰椎下缘平面。所有患者均行PCNL，合并肾结石者同期处理。术后拔管前均行腹部平片及B超检查，以B超检查结石直径小于0.3cm为结石取尽标准。结果187例嵌顿性输尿管上段结石手术均成功，成功率为100%，手术时间（25±10）min，术中出血10～100ml，结石取尽率为100%，住院时间6～9d。所有病例均未输血，或出现其它严重并发症。结论 PCNL治疗嵌顿性输尿管上段结石安全、快捷、有效，对于治疗嵌顿性输尿管上段结石可作为首选，值得在此类病例的治疗上大力推广。“,”Objective To evaluate the clinical effects and application of percutaneous nephrolithotomy (PCNL) for impacted upper ureteral calculi (IUUC). Methods One hundred eighty-seven cases of impacted upper ureteral calculi treated with PCNL were analyzed retrospectively in present study. The patients, 112 males and 75 females, aged from 17 to 75 years (median age49 years), and with a mean course of diseases of 13 months (ranged from 2 months to 8 years) were involved into present study. The average calculus size was 1.8×1.2 cm (ranged from 1.2 to 3.4 cm). All patients, including 138 with unilateral IUUC, 49 with bilateral IUUC, 56 with superinduced homolateral renal calculus,13 with impacted ureteral calculi in solitary kidneys,37 with renal inadequacy, 43 with undergoing ureterolithotomy, and 86 failed with ureteroscopic lithotripsy were treated with PCNL. The locations of ureteral calculi of all patients were above 4th lumbar inferior border. Stone-free status was defined by the standard of <3 mm by postoperative abdominal radiography and B ultrasonic. Results PCNL were successfully performed in all patients with the surgical time ranged 10~40 min, blood loss volume 10~100 mL. The rate of complete clearance of stones was 100%.The hospital stay ranged from 6 d to 9 d and the mean postoperative hospital stay was 3.5 d. No severe complications were occurred in the operative time. Conclusion Based on above study, we can draw a conclusion that PCNL is a safe,minimally invasive and effective treatment for the IUUC.It may be generalized and the first choice for the treatment of IUUC.