目的:探讨术前预置双J管在经皮肾镜取石术中的技巧和临床疗效,以期提高手术成功率。方法:2011~2013年对36例肾结石患者在经皮肾镜术前1~2周或肾穿刺前逆行置入双J管,采用灌注泵经导尿管行膀胱灌注,双J管逆流形成“人工肾积水”后再行治疗。统计分析肾穿刺成功率、手术时间及并发症发生率。结果:30例均一次性穿刺成功,6例行2~3次穿刺成功建立通道,穿刺成功率100%;手术时间30~90 min,平均(68±10.3)min,其中碎石(取石)时间5~40 min,平均22min;术中检测灌注压力为<30 cm H2O(1 cm H2O=0.098 kPa);术中无大出血,术后来出现感染性休克等并发症。结论:采用经皮肾镜术前1~2周或肾穿刺前逆行置入双J管,经导尿管行膀胱灌注,双J管逆流形成“人工肾积水”的方法,提高经皮肾穿刺的成功率,减少了再次顺行置管的程序,缩短了手术时间,具有手术时间短、创伤小及安全等优势,是经皮肾镜取石术治疗肾结石的一种安全、有效的方法。 Objective: To explore the preoperative double J tube percutaneous nephrolithotomy in the skills and clinical efficacy, in order to improve the success rate of surgery. Methods: From 2011 to 2013, 36 patients with nephrolithiasis were retrospectively treated with double J tube before percutaneous nephrolithotomy 1 ~ 2 weeks or before renal biopsy. The perfusion pump was used for urinary bladder perfusion and double J tube retrograde flow “Artificial hydronephrosis ” before treatment. Statistical analysis of renal puncture success rate, operation time and complication rate. Results: Thirty patients were successfully punctured by one time, and 6 patients were successfully punctured by two or three punctures. The puncture success rate was 100%. The operation time was 30-90 min (mean, 68 ± 10.3 min). The gravel time The average perfusion pressure was <30 cm H2O (1 cm H2O = 0.098 kPa) during operation. The patients had no major hemorrhage during operation, and postoperative complications such as septic shock were observed. Conclusion: Percutaneous nephrolithotomy preoperatively 1 to 2 weeks or retrograde renal biopsy before the double J tube, bladder catheterization through the catheter, double J tube countercurrent formation of “artificial hydronephrosis” method to improve the classics The success rate of percutaneous nephrolithotomy reduces the procedure of catheterization once again, shortens the operation time, has advantages of short operation time, small trauma and safety and is a safe and effective method for percutaneous nephrolithotomy for the treatment of kidney stones Methods.