【摘要】 目的:探讨完全平卧位下行逆行输尿管软镜碎石术(retrograde intrarenal surgery, RIRS)治疗上尿路结石的有效性及安全性。方法:回顾性分析2014年7月—2021年12月在江苏省中医院泌尿外科完成的41例完全平卧位下RIRS的上尿路结石患者的临床资料，作为观察组。同时选取24例同期采用截石位RIRS手术的患者作为对照组。比较2组住院时间、手术时间、结石清除率、术前及术后24 h内D-二聚体水平以及术后并发症发生率的差异。结果:2组患者在手术时间、住院时间、结石清除率、术后并发症方面差异均无统计学意义(P>0.05)。但观察组患者术后24 h内D-二聚体水平显著低于对照组，并且术后双下肢舒适度显著高于对照组，差异有统计学意义(P<0.05)。结论:对于高龄、结石负荷大预计手术时间较长或者截石位摆放困难的患者，选择完全平卧体位完成RIRS是安全有效的。更多还原

【Abstract】 Objective: To investigate the efficacy and safety of retrograde intrarenal surgery(RIRS) in treatment of upper urinary tract calculi in completely supine position. Methods: Clinical data of 41 patients with upper urinary tract calculi who underwent RIRS in the completely supine position between July 2014 and December 2021 were retrospectively analyzed as the observation group. Other 24 patients who underwent RIRS in the lithotomy position during the same period were also selected as the control group. The hospitalization time, operation time, stone clearance rate, D-Dimer level and postoperative complication rate of the two groups were compared. Results: There was no statistical difference between the two groups in terms of operative time, hospital stay, stone clearance rate or postoperative complications(P>0.05). However, the postoperative D-Dimer level of patients in the observation group was significantly lower than that of the control group, and the postoperative comfort level of lower limbs was significantly higher in the observation group than that in the control group(P<0.05). Conclusion: It is safe and effective to directly choose the supine position to complete RIRS surgery for patients who are elderly, have a large stone size or have difficulty in placing lithotomy position.更多还原