目的 :探讨输尿管软镜监视下经皮肾镜治疗鹿角状结石的安全性与有效性。方法 :部分性或完全性鹿角状结石患者11例,先在局麻下用膀胱镜置入双J管。2周后患者全麻下取膀胱截石位,用导丝置入输尿管软镜鞘,利用输尿管软镜进入肾盂或肾盏寻找结石。在B超引导下行经皮肾穿刺,然后在输尿管软镜监视下进行常规经皮肾镜操作,并在术后拍摄腹部平片来评价手术效果。结果:所有手术均顺利完成,无明显并发症,10例(90.9%)患者结石一期完全清除(直径2 mm以下结石视为完全清除),1例由于感染,一期手术未能完全碎石取石,二期经皮肾镜取石术(PCNL)联合输尿管软镜完全清除结石。其中5例有肾镜无法到达的肾盏内结石,经输尿管软镜套石篮取出。输尿管软镜监视下的穿刺与扩张过程更加精确,使得出血量减少,感染和其他并发症的发生率降低。结论:输尿管软镜监视下的同步经皮肾镜治疗鹿角状结石是有效与安全的操作,并且能够提高清石率。 Objective: To investigate the safety and efficacy of percutaneous nephrolithotomy for the treatment of antlers of calculi with ureteroscopy. Methods: Eleven patients with partial or complete antler stone were treated with cystoscopy in double J tube under local anesthesia. Two weeks later, the patients underwent general anesthesia to take lithotripsy of the bladder. The guidewire was inserted into the ureteroscope sheath, and the ureteroscope was used to enter the renal pelvis or calyx to look for stones. Under the guidance of B-percutaneous renal puncture, and then under the supervision of the ureteroscope underwent routine percutaneous nephrolithotomy, and postoperative abdominal plain film to evaluate the surgical effect. Results: All the operations were successfully completed without any complication. One patient (90.9%) had complete removal of stones one time (stones less than 2 mm in diameter were considered as complete removal), and one patient failed to complete the gravel because of infection Stone, two percutaneous nephrolithotomy (PCNL) combined with ureteroscopy completely remove stones. Among them, 5 cases had calyceal calculus which could not reach by nephrolithotomy and was taken out by ureteroscopy basket. Ureteroscopic monitoring of the puncture and expansion process more accurate, making the reduction of bleeding, infection and other complications decreased. Conclusions: Synchronous percutaneous nephrolithotomy under ureteroscopy is an effective and safe procedure for the treatment of staghorn stones, and can improve the rate of clear stones.