经皮肾镜联合输尿管镜一期治疗上尿路结石23例临床分析

目的探讨斜仰卧截石位下经皮肾镜联合输尿管镜一期治疗上尿路结石的临床应用。方法2012-2013年我科23例患者于全麻下采取斜仰卧截石位一期经皮肾镜联合输尿管镜行碎石取石术。23例患者中16例先行输尿管镜下碎石取石再行经皮肾镜碎石取石，7例患者同时分别进行经皮肾镜碎石取石及输尿管镜下碎石取石。结果23例患者术中术后均未输血，术中术后未发生感染性休克，无患者术中终止手术，无患者术中转开放手术。术后3d复查腹平片显示仅3例患者存在直径小于3ram结石残留，其余患者均无结石残留。23例患者术后。肾功能复查均正常。结论经皮肾镜联合输尿管镜一期治疗上尿路结石具有多种优点，选择合适的病例采用此法治疗上尿路结石，特别是肾结石合并输尿管结石是可行且有效的。

Percutaneous nephrolithotripsy combined ureterorenoscope lithotripsy simultaneously to treat the upper urinary tract stones of 23cases

Objective To explore the clinical application of Percutaneous nephrolithotripsy combined ureterorenoscope lithotripsy simultaneously to treat the upper urinary tract stones at lithotomy anaclisis position. Methods From 2010 to 2013,23 patients in our department undertake percutaneous nephrolithotripsy combined ureterorenoscope lithotripsy simultaneously to treat the upper urinary tract stones at the lithotomy anaclisis position.16 cases have ureterorenoscope lithotripsy first and then percutaneous nephrolithotripsy.7 cases have the both simultaneously. Results The total 23 cases none have blood transfusion,none have infectious shock, none terminate the operation during the procedure,none turn to open surgery.The KUB plain film after surgery shows only 3 cases have residual stones,but the diameter of the stones was less than 3 centimeters.All cases shows normal kidney function after surgery. Conclusion Percutaneous nephrolithotripsy combined ureterorenoscope lithotripsy simultaneously to treat the upper urinary tract stones at lithotomy anaclisis position is a splendid surgery.With suitable cases,especially kidney stone incorporate with ureter stone,this surgery is feasible and available.