一期微创经皮肾镜取石术（MPCNL）治疗双侧上尿路结石（附20例报告）

目的探讨一期微创经皮肾取石术（MPCNL）治疗双侧上尿路结石的疗效和安全性。方法总结一期微创经皮肾镜取石术治疗双侧上尿路结石20例的效果和并发症。结果双侧肾结石患者7例，结石清除率85％，平均手术时间160min；一侧输尿管上段结石对侧肾结石患者5例，结石清除率89％，平均手术时间142min：双侧输尿管上段结石患者8例，结石清除率92％，平均手术时间128min。手术出血量5-450ml，平均150ml。手术后25％（5／20）的患者出现超过38．0℃的发热，所有患者肾功能恢复正常，无严重术后并发症。结论对于身体情况良好，结石清除相对容易的双侧上尿路结石患者，一期MPCNL是安全可靠的，能减少患者总住院时间和费用。

Primary minimally invasive percutaneous nephrolithotomy in treatment of bilateral upper urinary stones (Report of 20 cases)

Objective To study the effect and safety of primary minimally invasive percutaneous nephrolithotomy （MPCNL） in treatment of bilateral upper urinary stones. Methods The effect and complications of primary minimally invasive percutaneous nephrolithotomy in treatment of bilateral upper urinary stones for 20 patients were summarized retrospectively. Results The stone-free rate was 85% in 7 patients with bilateral kidney stone. The mean operating time was 160 min （range from 100 to 240）. The stone-free rate was 89% in 5 patients with one side kidney stone and the other side upper ureteral stone. The mean operating time was 142 min（range from 80 to 210 min）. The stone-free rate was 92% in 8 patients with bilateral upper ureteral stones, the mean operating time was 128 min（range from 30 to 180 min）. The mean blood loss was 150 ml（range from 5 to 450 ml）. 25%（5/29） patients had fever with body temperature morn than 38.0℃. All patients with renal function were returned to normal. Without serious postoperative complications were found. Conclusion It is reliable and safe for primary minimally invasive percutaneous nephrolithotomy in treatment of the patients with well genral status and relative easy of removed stone.