微创经皮肾镜结合输尿管软、硬镜治疗肾结石(附128例报告)

目的探讨微创经皮肾镜结合输尿管软镜治疗肾结石的方法及疗效。方法微创经皮肾镜气压弹道碎石结合输尿管软、硬镜钬激光碎石治疗肾结石128例,结石直径1.8～5.3cm,多为复杂的多发盏内结石或鹿角型结石。结果128例均采用经皮肾镜气压弹道碎石结合输尿管软、硬镜钬激光碎石,一次手术结石总清除率为72.7%（93/128）,二次手术结石总清除率42.7%（15/35）,三次手术结石总清除率53.3%（8/15）,7例残留小结石患者术后行体外冲击波治疗,3个月后随访结石清除5例。所有病例无严重并发症发生。结论微创经皮肾镜弹道碎石结合输尿管软、硬镜钬激光碎石治疗肾结石具有结石清除率高、创伤小、并发症少等优点,是安全可靠肾结石治疗方法。

Minimally Invasive Percutaneous Nephrolithotomy with Ureteral Hard and Soft Lens Treatment of Renal Calculi Report of 128 Cases

Objective To evaluate the combination of minimally invasive percutaneous nephrolithotomy flexible ureteroscope and efficacy of the treatment method of kidney stones.Methods Minimally invasive percutaneous nephrolithotomy combined pneumatic lithotripsy of ureteral soft and hard lens holmium laser lithotripsy for 128 cases of kidney stones,stone diameter1.8cm～5.3cm,more complex with multiple lamp types within the stones or staghorn stones.Results Were 128 cases of percutaneous nephrolithotomy combined pneumatic lithotripsy of ureteral soft and hard lens holmium laser lithotripsy,a surgical stone clearance rate of the overall 72.7%（93/128）,second surgery stone clearance rate of 42.7% overall（15/35）,three surgical procedures to the overall stone clearance rate of 53.3%（8/15）,seven cases of residual stones in patients with a small line of extracorporeal shock wave therapy after 3 months follow-up of stone removal in 5 cases.No serious complications occurred in all cases.Conclusion Minimally invasive percutaneous nephrolithotomy lithotripsy in the ureter with soft and hard lens holmium laser lithotripsy for renal calculi with a stone clearance rate,trauma and fewer complications,etc.,are safe and reliable treatment for kidney stones.