【摘要】 目的总结肾下盏入路单通道微创经皮肾穿刺取石术(MPCNL)联合输尿管镜下取石术(URL)治疗肾结石的经验。方法建立经皮肾下盏通道后行URL,在完成肾盂内碎石解除肾盂出口处梗阻后输尿管内放置双J管,然后改行单通道MPCNL。结果18例均一次肾造瘘成功。仅1例行URL时因输尿管镜未能触及结石失败,单行PCNL。手术平均时间107min。1次取石13例,2次取石5例。18例中4例有残留结石后均行体外冲击波碎石(ESWL),仅1例随访6个月仍有少量残留结石。术中、术后无严重并发症。结论肾下盏入路单通道MPCNL联合URL治疗肾结石具有效率高、结石取净率高、肾损伤小、并发症少等优点,可作为治疗以肾下盏及肾盂为主肾结石首选方法。更多还原

【Abstract】 Objective To sum up the experience in the treatment of renal calculi with single-channel passing lower calyceal minimall invasive percutaneous nephrolithotomy (MPNCL) combined with ureteroscopic lithotripsy (URL).Methods Before URL was performed,percutaneous lower kidney calyx channel was established.After completing the intra renal pelvis lithotrity to relieve the renal pelvis outlet obstruction and put double J stent in ureter,the single-channel MPNCL was performed.Results It was successful for all the 18 cases in the first time kidney fistula.Only 1 case failed because the ureteroscopy didn’t touch the stone when performing URL and only did PCNL.The average operating time was 107 min.Thirteen cases succeeded in the first operation,and 5 cases in the second operation.Among the 18 cases,4 cases having remnant stone were all subjected to ESWL,and only one case still had few remnant stone after follow-up for 6 months.No severe complications occurred during or after the operation.Conclusion Single-channel passing lower calyceal MPNCL combined with URL is a very efficient therapy for renal calculi.It also has the virtue of high clearance rate,low kidney injury and less complication,and can be used as the first choice of therapy for renal calculi in lower calyceal and renal pelvis.更多还原