经皮肾镜联合不同软镜治疗鹿角形肾结石的研究

目的：评价单通道经皮肾镜联合不同软镜下钬激光碎石治疗鹿角形肾结石的手术效果。方法：B超引导穿刺，单通道经皮肾镜联合膀胱软镜和输尿管软镜，行钬激光碎石治疗鹿角形。肾结石93例。结石直径2．6～5．4cm。结果：93例均采用单通道经皮。肾镜联合软镜下钬激光碎石，一期手术平均手术时间为108min，完全清除率为83．9％（78／93），二期手术平均手术时间为43min，结石完全清除率87．5％（7／8）。全部病例均无肾盂穿孔、气胸、腹腔内脏器官损伤等严重并发症发生。结论：单通道经皮。肾镜联合不同软镜下钬激光碎石治疗鹿角形肾结石具有碎石成功率和结石排净率高、创伤小、手术时间短、并发症少、周围脏器损伤风险小等优点，是一种治疗鹿角状肾结石的理想方法。

Study of Percutaneous Nephrostomy Combined with Flexible Cystoscope or Flexible Ureteroscope for Staghorn Calculi

Objective：To evaluate the efficacy of single channel percutaneous nephrostomy combined with flexible cystoscope or flexible ureteroseopie lithotripsy using holmium laser in patients with renal staghorn calculi . Methods：93 cases of renal staghorn calculi were treated by single channel percutaneous nephrostomy holmium laser combined with flexible cystoscope or flexible ureteroscopic lithotripsy under B-ultrasound guidance,stone diameter 2.6cm- 5.4cm. Results：All patients were treated by single channel percutaneous nephrostomy combined with flexible cystoscope or flexible ureteroscopic lithotripsy using holmium laser. The average operation time of the first stage was 108 rain and the clearance rate reached 83.9% （78/93）. The average operation time of the second stage was 43 rain and the clearance rate reached 87.5% （7/8）. No serious complications occurred in all cases. Conclu- sions：Single-channel PCNL combined with flexible cystoscope or flexible ureteroscopic lithotripsy using holmium laser for renal staghorn calculi has the advantages of effectiveness, mini-invasion,less operative duration and safe ty,which is a ideal technique for treating the renal staghorn calculi.