多镜联合治疗复杂性肾结石的疗效观察

Observation on the Efficacy of Multiplex-endoscopy Combination Therapy for Complex Renal Cal-culi

【目的】探讨多镜联合治疗复杂性肾结石的疗效。【方法】多镜联合治疗复杂性肾结石61例，选择输尿管硬镜联合组合式输尿管软镜碎石35例；单通道经皮肾镜联合组合式输尿管软镜碎石26例。【结果】输尿管硬镜联合组合式输尿管软镜碎石35例结石患者中，碎石成功率97．14％（34/35），结石清除率为83．86％（29/35）。碎石手术时间50～100 min。术后住院2～7 d；单通道经皮肾镜联合组合式输尿管软镜碎石26例患者全部肾盂及主要肾盏结石均顺利击碎并排出，一期清除率为80．77％（21/26），总结石清除率为92．30％（24/26）。碎石手术时间50～140 min。肾造瘘管留置时间5～35 d ，术后住院6～10 d。【结论】多镜联合治疗复杂性肾结石，可提高复杂性肾结石的结石清除率，减小手术创伤，缩短手术时间，降低手术风险及并发症，是复杂性肾结石较好的治疗方法。

[Objective]To explore the efficacy of multiplex-endoscopy combination therapy for complex renal calculi .[Methods]A total of patients with complex renal calculi received multiplex-endoscopy combination therapy .Among them ,35 patients underwent rigid combined with flexible ureteroscope lithotripsy ,while 26 patients underwent single-channel percutaneous nephroscopy combined with flexible ureteroscope lithotripsy .[Results] In the 35 patients undergoing rigid combined flexible ureteroscope lithotripsy ,the success rate was 97 .14% （34/35） , and the stone free rate was 83 .86% （29/35） ,and the surgery time was 50～100min ,and the length of stay after operation was 2～7 days .In the 26 patients undergoing single-channel percutaneous nephroscope combined with flexible ureteroscope lithotripsy ,all the stones in renal pelvis and many stones in kidney calices were eliminated , and the stone free rate in the first stage was 80 .77% （21/26） ,and the total stone free rate was 92 .30% （24/26） , and the surgery time was 50～140min ,and the indwelling time of nephrostomy tube was 5～35 days and the length of stay after operation was 6～10 days .[Conclusion] Multiplex-endoscopy combination therapy for complex renal calculi can improve the stone free rate ,reduce operation wound ,shorten operation time and decrease operation risk and complications .Therefore ,it is a better treatment method for complex renal calculi .