Objective Minimally invasive surgical intervention has become a preferred procedure for urinary stones. This article is to investigate the complications of ultrasound-guided percutaneous nephrolithotomy (PCNL) with holmium laser lithotripsy and the EMS-III system in the treatment of urinary stones. Methods We retrospectively analyzed 917 cases of PCNL performed with holmium laser lithotripsy and the EMS-fll system, compared the complications between the holmium laser and EMS groups, and explored the preventive measures of the complications. Results The rates of necessitated blood transfusion were 5.9% and 8.1% in the holmium laser and the EMS group, respectively; the incidences of systemic inflammatory response syndrome ( SIRS) were 11.6% and 5.6% ; and the rates of stone retention were 23.6% and 19. 8%. Some rare and serious complications included bleeding which needed surgical intervention, septic shock, air embolism, renal fistula into the inferior vena cava, respiratory arrest and prolonged tracheal intubation. Conclusion As a popular means of managing urinary stones, PCNL may invite serious complications , and its safety needs to be further improved.%目的 微创术式已成为治疗泌尿系结石的首选术式.文中分析超声引导下经皮肾镜钬激光取石术式及瑞士EMS-Ⅲ碎石清石系统治疗上尿路结石的常见严重并发症. 方法 对采用2种超声引导下术式开展的917例次经皮肾镜取石术( percutaneous nephrolithotomy,PCNL)进行回顾性分析,并对各种并发症的发生情况及防治措施进行探讨.按手术方式分为钬激光组和气压弹道组. 结果 钬激光组和EMS组术中需输血的出血发生率分别为5.9％和8.7％,全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)发生率为11.6％和5.6％,结石残余率为23.6％和19.8％.严重并发症包括需行外科处置的出血、感染性休克、气栓、肾造瘘管置入下腔静脉、呼吸心跳骤停及气管插管延迟拨管. 结论 经皮肾镜虽已成为治疗泌尿系结石的重要手段,但仍有可能发生严重并发症,应重视并进一步提高其安全性.
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