完全俯卧位经皮肾镜术联合输尿管镜术治疗复杂性肾输尿管结石疗效观察

The clinical effect of percutaneous nephrolithotomy surgery combined with ureteroscopy on completely prone position in the treatment of refractory kidney ureteral calculi

目的：探讨完全俯卧位经皮肾镜术联合输尿管镜术治疗复杂性肾输尿管结石的疗效。方法对12例复杂性肾输尿管结石患者采用完全俯卧位经皮肾镜术联合输尿管镜术治疗，观察治疗效果。结果12例患者均只行一期单通道手术，10例患者无残留结石，2例残留少量残石。手术时间30～110分钟，平均58分钟。一次性手术结石取净率83.3％（10／12），无再次手术取石患者，2例肾结石少量残留，未再次手术或体外冲击波碎石。术中及术后均未发生明显出血、发热等症状，未发生周围脏器损伤。2例结石未取净者经保守治疗后结石排净。6个月后行B超，腹部平片（ KUB）或CT检查，未见结石残留或复发。结论完全俯卧位经皮肾镜术联合输尿管镜术治疗复杂性肾输尿管结石安全可行，手术效果良好。

Objective To determine effectiveness and feasibility with respect to the joint percutaneous nephrolithotomy surgery with ureteroscopy technique on completely prone position in the treatment of refractory kidney ureteral calculi.Methods The joint per-cutaneous nephrolithotomy surgery with ureteroscopy technique on completely prone position was applied to 12 patients with refractory kidney ureteral calculi.The clinical effectiveness was observed.Results All patients received one-stage single channel operation.After the operation,10 patients had no residual stone and 2 patients had stone fragments.The operation time was 30-110 min with average 58 min.The net rate of stone taken was 83.3%（10/12）.For the 2 cases with stone fragments,no re-surgery and in vitro lithotripsy was performed.There was no intra-or post-operative hemorrhage and peripheral viscera injury.The 2 cases with stone fragments were evacua-ted after conservative treatment.There was no residual stone or recurrence proved by KUB or CT after 6 months of the operation.Con-clusion Percutaneous nephrolithotomy surgery combined with ureteroscopy technique on completely prone position for refractory kidney ureteral calculi is safe and effective.