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目的:总结标准通道下以肾镜为主结合输尿管镜同时应用以降低上尿路结石残留率的临床经验。方法:2007年8月～2011年1月采用B超引导下建立标准通道以肾镜为主结合输尿管镜同时应用治疗上尿路结石患者1 120例,并记录手术时间、结石清除率、手术并发症等临床资料。结果:所有患者均成功建立F24皮肾通道,平均手术时间53min,术中失血量50～100ml,一期净石率91.2%(1 021/1 120)。38例患者术后发热,经抗感染治疗后好转;3例因术后继发出血,行选择性肾动脉栓塞,未出现气胸、肠道损伤等严重并发症。结论:标准通道下肾镜结合输尿管镜处理上尿路结石高效、安全,结石残留率低。
OBJECTIVE: To summarize the clinical experience of using standard renal nephroscope combined with ureteroscopy to reduce the residual rate of upper urinary tract stones. Methods: From August 2007 to January 2011, 1 120 cases of upper urinary tract stones were treated with B-ultrasound guided standard pathology combined with ureteroscopy. The operative time, stone removal rate, surgical complications Disease and other clinical data. Results: The F24 renal access was successfully established in all patients. The mean operation time was 53 minutes. The blood loss was 50 ~ 100ml and the first stage stone was 91.2% (1 021/1 120). Thirty-eight patients had fever after operation, and were improved after anti-infective therapy. Three patients suffered from postoperative secondary hemorrhage undergoing selective renal artery embolization without any serious complications such as pneumothorax and intestinal injury. Conclusion: The standard pathways of renaloscopic and ureteroscopic treatment of upper urinary tract stones with high efficiency and safety, low residual stone.