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目的:总结输尿管镜取石术(URL)联合微创经皮肾穿刺取石术(mini-PCNL)或电子输尿管软镜(digital flexible ureteroscopy)治疗复杂性输尿管石街的临床经验。方法:对29例复杂性输尿管石街患者,采用输尿管镜下用气压弹道碎石器,将结石上推到肾盂后再结合mini-PCNL顺行取石或电子输尿管软镜钬激光碎石。结果:11例患者采用一期手术取石成功,18例患者采取二期手术取石成功。全部患者术中及术后均无大出血、输尿管穿孔、输尿管撕脱、菌血症等并发症。结论:采用URL结合mini-PCNL或电子输尿管软镜治疗复杂性输尿管石街减少了严重并发症的发生,不仅有效地清除了输尿管石街,也可同时处理肾盂肾盏内结石,结石清除率高,残石率低,值得在临床上推广。
OBJECTIVE: To summarize the clinical experience of ureteroscopic lithotripsy (URL) combined with mini-PCNL or digital flexible ureteroscopy in the treatment of complex ureteral stone street. Methods: Twenty-nine patients with complicated ureteral stone street were treated with pneumatic lithotripsy under ureteroscope. The stones were pushed to the renal pelvis and then combined with mini-PCNL or ureteroscopic holmium laser lithotripsy. RESULTS: Eleven patients underwent primary surgery successfully and 18 patients underwent secondary surgery successfully. No intraoperative and postoperative patients with major bleeding, ureteral perforation, ureteral avulsion, bacteremia and other complications. Conclusion: The combination of URL and mini-PCNL or electronic ureteroscope for the treatment of complicated ureteral stone street reduces the incidence of serious complications. It not only effectively eliminates the ureteral stone street, but also simultaneously treats the stones in the renal pelvis and calyx, and has a high rate of stone clearance , Low rate of residual stone, it is worth promoting in the clinic.