联合不同口径多通道经皮肾镜取石术治疗复杂性肾结石

目的探讨联合微通道及标准通道进行多通道经皮。肾镜取石术（percutaneous nephrolithotomy，PCNL）治疗复杂性肾结石的临床疗效和安全性。方法2008年1月～2013年2月，采用联合微通道及标准通道进行多通道PCNL术治疗复杂性肾结石121例。包括鹿角形肾结石73例，肾多发结石48例。合并脓肾31例。结果121例共建立281个通道。其中一期单通道36例，双通道70例，三通道15例；二期手术56例，其中49例新建通道60个。手术时间34～127min，平均72min。结石总清除率90．9％（110／121）。术后无严重并发症。结论联合不同口径多通道PCNL治疗复杂性肾结石安全有效，清石率高，并发症低，住院周期短，可作为一种理想的治疗术式。

Multi-tract Percutaneous Nephrolithotomy for Complex Renal Calculi

Objective To discuss the clinical efficacy and safety of multi-tract percutaneous nephrolithotomy using minimally invasive tract and standard tract for complex renal calculi. Methods We retrospectively analyzed the clinical data of 121 patients undergoing multi-tract percutaneous nephrolithotomy using minimally invasive tract and standard tract for complex renal calculi from January 2008 to February 2013, including 73 cases of staghorn calculi, 48 cases of multiple renal calculi. 31 cases combined with pyonephrosis. Results 281 percutaneous renal tunnels were successfully established in 121 cases, of which single tunnel was used in 36 cases, 2 tunnels were used in 70 cases, and 3 tunnels were used in 15 cases in one-stage. 56 cases had a two-stage PCNL, including 60 new tunnels in 49 cases. The average operation time was 72 min （range, 34 - 127 min） , and the overall stone clearance rate was 90.9% （110/121）. No severe postoperative complications occurred. Conclusions Multi-tract percutaneous nephrolithotomy for complex renal calculi is effective and safe. It has the advantage of high stone clearance rate, less complications and shorter hospital stay.