微创经皮肾镜取石术联合Ⅱ期逆行输尿管软镜治疗复杂性肾结石96例

目的 探讨微创经皮肾镜取石术联合Ⅱ期逆行输尿管软镜治疗复杂性肾结石的安全性及有效性.方法 对九江学院附属都昌医院泌尿外科2012年1月至2014年12月收治的96例复杂性肾结石采用微创经皮肾镜取石术联合Ⅱ期逆行输尿管软镜治疗,并对临床资料进行回顾性分析.结果 所有手术均成功建立工作通道并有效行Ⅰ期微创经皮肾镜取石术,术后3～5d行二期逆行输尿管软镜治疗,Ⅱ期结石清除率为95.8％ (92/96).5例患者于术后行辅助体外冲击波碎石治疗,4例碎石后结石完全排出,1例结石残留,残留结石直径＜ 5mm.其中出现1例并发输尿管穿孔,1例感染,均予保守治疗后治愈.未出现气胸、大出血等重大并发症.结论 微创经皮肾镜取石术联合Ⅱ期逆行输尿管软镜治疗是一种复杂性肾结石安全、有效的方法,具有术中损伤小、住院时间短、恢复快、结石清除率高、并发症低等优点.

Combined minimally invasive percutaneous nephrolithotomy and retrograde flexible ureteroscopy in the treatment of complicacy kidney stone

Objectives To investigate the safety and efficacy of the minimally invasive percutaneous nephrolithotomy (mPCNL) and retrograde flexible ureteroscopy in the treatment of complicacy kidney stone.Methods 96 cases of patients with complicacy kidney stone were treated with mPCNL and retrograde flexible ureteroscopyanalyzed retrospectively from Jan 2012 to Dec 2014 and analyzed retrospectively.Results All surgeries were successful and no major complications were found in these patients.The overall stone-free rate was 95.8％ (92/96) after second stage procedures and only 5 patients underwent assisted extracorporeal shock wave lithotripsy (ESWL).Conclusions The mPCNL and retrograde flexible ureteroscopy in the treatment of complicacy kidney stone is safe and effective with less trauma,quick recovery,shorter hospitalization,higher stone-free rate and low complications.