Ⅱ期经皮肾镜碎石联合逆行输尿管软镜治疗PCNL术后残余结石

摘要

目的:探讨Ⅱ期经皮肾镜碎石联合逆行输尿管软镜处理PCNL残余结石的有效性及安全性.方法:回顾性分析2013年3月~2016年9月间使用经皮肾镜联合逆行输尿管软镜Ⅱ期处理PCNL残余结石患者的临床资料.患者取改良的半截石斜卧位,两名医师分别采用肾镜和逆行输尿管软镜进行碎石操作.结果:36例病例中,残余结石STONE评分为6.7分,平均耗时26.3 min,Ⅱ期术后结石总清除率为94%(34/36),不伴有明显并发症.结论:Ⅱ期经皮肾镜联合逆行输尿管软镜处理PCNL残余结石能充分发挥现有技术和器械的优点,其安全性高,可行性强.%Objective: To investigate the efficiency and safety of percutaneous nephrolithotomy with retrograde flexible ureteroscopy in the treatment of residual renal calculi after PCNL in second stage.Methods: We retrospectively reviewed the cases undergoing second-stage percutaneous nephrolithotomy with retrograde flexible ureteroscopy between March 2013 and September 2016.The patients were placed in the Galdakao-modified Valdivia supine position.Two urologists manipulated nephroscopy and regtrograde flexible ureteroscopy respectively in the same time.Results: Thirty-six cases were investigated, and the residual calculi S.T.O.N.E.scores were 6.7 in average.The procedure lasted 26.3 min.The stone free rate was 94% (34/36) without significant complications.Conclusions: Treating residual renal calculi after PCNL by percutaneous nephrolithotomy with retrograde flexible ureteroscopy is feasible and safe.It can make full use of the advantage of different instruments.