目的：分析单通道经皮肾镜取石术（PCNL ）术后导致结石残留的高风险因素。方法整理该院自2011年6月至2013年12月行单通道 PCNL 术的262例患者的临床资料，分类总结术后残石成因。结果实施手术262例，42例（16％）出现1期术后残石。21例系复杂类型结石，7例与术中出血等并发症有关，7例因结石体积过大，碎石过程中结石散落导致，3例与肾内集合系统解剖异常有关，3例系术式特点受限，1例系术者操作不熟练所致。结论单通道 PCNL 术后残石形成的高风险因素主要是结石复杂、结石体积大及出血影响，变异的肾内集合系统、术式缺陷及术者操作不熟练也有一定的关系。%Objective To investigate the risk factors and countermeasure of residual stones after single‐channel percutaneous nephrolithotomy for higher stone‐free rate and better operation result .Methods All patients who underwent single‐channel percu‐taneous nephrolithotomy in our hospital from June 2011 to December 2013 were retrospected and the cause of residual stones were analyzed .Results There were 42 patients who had residual stones after operation among total 262 patients undergone single‐chan‐nel PCNL .21 patients had residual stones because the stones they burdened were too complex .7 patients were concerned with com‐plications such as intraoperative hemorrhage .The stone fragments scattered into the calices in 7 patients with overlarge stone during fragmentation .The other causes concerned with stone residue included anatomic structural abnormalities of the kidneys(3 patients) , operation itself inherent limitations(3 patients) ,insufficient practice and experience in operation(1 patients) .Conclusion The main causes concerned with residual stones of single‐channel PCNL are complexity of urinary calculi ,bleeding ,scattering of stone frag‐ments and anatomic structural abnormalities of the kidney .
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