经皮肾镜气压弹道联合钬激光碎石治疗复杂性上尿路结石

Treatment of mPCNL combining pneumatic and YAG holmium laser lithotripsy to complex upper urinary stone

目的 探讨经皮肾镜气压弹道联合钬激光碎石对复杂性上尿路结石的治疗效果.方法 对218例复杂性上尿路结石患者采用经皮肾镜气压弹道联合钬激光碎石治疗的疗效结果进行回顾性分析.结果 218例患者均一次性穿刺成功建立碎石通道,其中162例采用气压弹道联合钬激光碎石,34例单独采用钬激光碎石,22例单独采用气压弹道碎石;182例患者I期手术结石清除干净（结石清除率83.5％）,24例有小直径结石残余,12例择期行mPCNL二期手术;术中术后均未出现明显的并发症.结论 经皮肾镜下钬激光联合气压弹道碎石术治疗复杂上尿路结石,具有安全性好、结石清除率高、并发症少等优点.

Objectives To investigate the therapeutic effect of mPCNL combining pneumatic and YAG holmium laser lithotripsy.Methods To analyze the clinical data of 218 patients in our hospital who accepted the mPCNL combined pneumatic and YAG holmium laser lithotripsy retrospectively from January 2010 to June 2013.Results The lithotripsy path of 218 patients were successfully established once a time; Among them,162 cases were treated with pneumatic combining holmium YAG laser lithotripsy,34 cases were treated with YAG laser lithotripsy alone,22 cases were trested with pneumatic lithotripsy alone; 182 cases with cleaned stones in one-stage operation （stone clearance rate 83.5%）,24 cases still had small diameter residual stones and 12 cases underwent elective mPCNL.No significant Intraoperative and postoperative complications.Have been found.Conclusions The treatment of mPCNL combined with pneumatic and YAG holmium laser lithotripsy to complex upper urinary stone has the advantage of safety,highly stone clearance rate and fewer complications.