侧卧位微创经皮肾穿刺碎石术联合输尿管镜碎石术治疗复杂性肾结石

目的探讨侧卧位微创经皮肾穿刺碎石术联合输尿管镜碎石术治疗复杂性肾结石的疗效及安全性。方法回顾性分析采用侧卧位微创经皮肾穿刺碎石术联合输尿管镜碎石术治疗复杂性肾结石78例患者的临床资料,观察疗效。结果 75例采用侧卧位微创经皮肾穿刺碎石术联合输尿管镜碎石术手术顺利,3例肾穿刺不成功改为开放手术,肾穿刺成功率为96.15%(75/78)。75例手术者中,62例行1次穿刺取石,13例行2次手术取石。1次取净结石55例,2次取净结石9例;单通道取石57例,多通道取石18例;结石取干净64例,残留结石11例,结石取净率为85.33%(64/75)。结论侧卧位微创经皮肾穿刺碎石术联合输尿管镜碎石术治疗复杂性肾结石,安全有效,患者耐受性好,是临床治疗复杂性肾结石的理想方法。

Treatment of complicated renal calculus with ureteroscopy combined with minimally invasive percutaneous nephrolithotomy under lateral position

Objective To evaluate the curative effect and safety of treatment of complicated renal calculus with ureteroscopy combined with minimally invasive percutaneous nephrolithotomy(PCNL) under lateral position. Methods The clinical data of 78 patients with complicated renal calculus,who treated by ureterosopy combined with PCNL,were retrospective analysis and to observe the curative effect. Results The surgery of ureterosopy combined with PCNL in seventy-five patients were successfully,and 3 patients were changed to open surgery,success rate of renal biopsy was 96.15%(75/78).In the 75 patients,there were 62 patients punctured one time to clear stones,and 13 patients punctured twice to clear stones.Stones were cleared in the first surgery in 55 patients,and stones were cleared in the second surgery in 9 patients.Stones were taken with single-channel in 57 patients and multi-channel in 18 patients.Stone-free in 64 patients and residual stones in 11 patients,the stone-free rate was 85.33%. Conclusion Ureteroscopy combined with minimally invasive PCNL under lateral position for treatment of complicated renal calculus,safe,effective and well tolerated in patients,is the ideal method for clinical and treatment of complicated renal calculus.