【摘要】 目的 探讨经腹腹腔镜联合输尿管软镜同期手术治疗复杂性输尿管上段结石合并同侧肾结石的临床可行性及安全有效性。方法 选择我院收治的复杂性输尿管上段结石并同侧肾结石的患者72例，按手术方式分为两组，对照组36例行输尿管镜取石术+经皮肾镜碎石取石术，观察组36例行经腹腹腔镜下输尿管切开取石联合输尿管软镜碎石取石术。比较两组围手术期指标及并发症发生情况。结果 观察组平均住院时间、手术时间短于对照组，住院费用及术中出血量少于对照组（P<0.05）；两组术后结石残余、肌酐水平、介入栓塞止血、术后疼痛评分及术后菌血症发生例数比较，P>0.05。观察组肾积水改善情况优于对照组，术后输尿管狭窄例数少于对照组（P<0.05）。结论 经腹腹腔镜联合输尿管软镜取石是治疗复杂性输尿管上段结石并同侧肾结石的安全、有效的方法。更多还原

【Abstract】 Objective To explore the feasibility, safety and effectiveness of stone removal by laparoscopy combined with flexible ureteroscopy in the treatment of complex upper ureteral stone and ipsilateral kidney stone.Methods 72 patients with complex upper ureteral stone and ipsilateral kidney stone in our hospital divided into two groups according to surgical methods, 36 cases in each group. The control group underwent ureteroscopic stone removal and percutaneous nephrolithotomy.The observation group underwent laparoscopic ureterolithotomy combined with flexible ureteroscopy lithotripsy. The perioperative indicators, stone clearance rate and occurrence of complications were compared between the two groups.Results The average hospitalization time and surgical time in the observation group were shorter than those in the control group, the hospitalization cost and intraoperative blood loss were less than those in the control group(P<0.05). There were no statistically significant differences in postoperative stone residue, elevated creatinine, interventional embolization hemostasis,postoperative pain score and the number of cases of postoperative bacteremia. The improvement of hydronephrosis in the observation group was better than that in the control group, and the number of postoperative ureteral stricture cases was less than that in the control group(P<0.05). Conclusion Laparoscopy combined with flexible ureteroscopy in the treatment of complex upper ureteral stone and ipsilateral kidney stone is safe and effective.更多还原