腰肋悬空仰卧位经皮肾镜标准通道双导管碎石清石系统与微通道钬激光治疗复杂性输尿管上段结石效果比较

目的：比较腰肋悬空仰卧位下经皮肾镜（PCNL）标准通道（F20）双导管Cyberwand碎石清石系统与微通道（F16）钬激光碎石两种方法治疗复杂性输尿管上段结石的疗效。方法：回顾性分析2010年3月～2010年8月应用腰肋悬空仰卧位行标准通道（F20）PCNL双导管Cyberwand碎石清石系统和微通道（F16）（mPCNL）经皮肾镜钬激光治疗复杂性输尿管上段结石34例的临床资料，比较两种方法的碎石时间、碎石率、清石率等临床相关指标的差异。结果：双导管组（n=18）的碎石率为100％（18／18），清石率为95％（17／18），平均手术时间（11±5）min；钬激光组（n=16）的碎石率为95％（15／16），清石率分别为81％（13／16），平均手术时间（20±6）min。两种方法碎石率比较差异无统计学意义（P〉0．05）；清石率双导管组优于钬激光组（P〈0．05）；手术时间双导管组优于钬激光组（P〈0．05）。结论：腰肋悬空仰卧位下PCNL治疗输尿管上段碎石，标准通道（F20）双导管Cyberwand碎石清石系统较微通道（F16）钬激光有较高的清石率，且可以显著节约碎石时间。

Comparison of Micro-channel Holmium Laser Lithotripsy and Normochannel Novel Dual Probe Lntracorporeal During Percutaneous Nephrolithotomy by Flank-suspended Supine Position in Curing of Complex Upper Ureteric Calculi

Objective:To compare the efficacy of micro-channel holmium laser lithotripsy and standard channell （F20）Novel Dual Probe（cyberwand） Intracorporeal dealing with complex upper ureteric calculi during microchannel percutaneous nephrolithotomy in flank-suspended supine position.Methods:34 cases were separated into two groups and analyzed the clinical parameters including the average time of lithotripsy,the rate of clearance and the rate of macadam.Result:The average time of lithotripsy in cyberwand Intracorporeal group（was 11 min） and the rate of complications（11%） were lower than that in laser group（P<0.05）.The clearance rate of stone in cyberwand group（95%） was higher than that in laser group（81%）（P<0.05）;There is no difference between the two groups in the rate of macadam（P>0.05）.Conclusions:Normochannel(F₂₀) percutaneous nephrostomy with cyberwand Intracorporeal for complex upper ureteric calculi has more advantages and higher clearance than microchannel laser lithotripsy group.