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目的:探讨微创经皮肾镜联合顺行组合式输尿管软镜处理鹿角形肾结石的有效性及安全性。方法:自2012年3月~2013年6月采用微创经皮肾镜联合组合式输尿管软镜处理鹿角形肾结石患者16例,其中完全性鹿角形结石3例,不完全性鹿角结石13例。结果:所有患者均采用单通道碎石,1例因术中出血,输尿管软镜无法有效碎石,改行二期顺行输尿管软镜钬激光碎石,余15例患者一期联合组合式输尿管软镜成功处理残留结石。平均手术时间(117.5±15)min,一期结石清除率为97.6%(15/16)。术中未出现大出血、尿源性脓毒血症、肠道损伤、胸膜损伤等严重并发症。结论:微创经皮肾镜联合组合式输尿管软镜治疗复杂性肾结石安全有效,在熟练掌握手术操作的前提下可以明显减少并发症,值得临床推广。
Objective: To investigate the effectiveness and safety of minimally invasive percutaneous nephrolithotomy combined with cis-ureteral soft-lens in the treatment of antler kidney stones. Methods: From March 2012 to June 2013, 16 patients with antler kidney stones were treated with minimally invasive percutaneous nephrolithotomy combined with combined ureteroscopy. Among them, 3 were complete antler calculus and 13 were incomplete antler calculus . Results: All the patients were treated with single-channel lithotripsy. One patient had bleeding due to intraoperative bleeding and the ureteroscope failed to obtain effective lithotripsy. The second phase of anterograde ureteroscopic holmium laser lithotripsy was performed. In the remaining 15 patients, the combined ureteral soft- Mirror successful treatment of residual stones. The average operation time (117.5 ± 15) min, a stone clearance rate was 97.6% (15/16). No major bleeding during surgery, urinary sepsis, intestinal injury, pleural injuries and other serious complications. Conclusion: The minimally invasive percutaneous nephrolithotomy combined with combined ureteroscopy is safe and effective in treating complex renal calculi. It can significantly reduce the complication under the premise of proficiency in surgical operation and is worthy of clinical promotion.