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经皮肾镜碎石术（PCNL）已广泛应用于肾结石的治疗，30多年来，PCNL手术体位从最初的俯卧位扩展到仰卧位、侧卧位，并经历了多种 PCNL 手术体位的改良。俯卧位、仰卧位和侧卧位PCNL具有确切的可行性和安全性，改良手术体位更提供了同时顺行 PCNL和逆行尿路内镜的操作，不同程度上提升了碎石的成效。充分认识不同 PCNL体位的穿刺特点能为手术体位的合理选择和进一步体位改良提供依据。“,”Percutaneous nephrolithotomy ( PCNL ) has been widely used in the treatment of kidney stones.Since more than 30 years ago,PCNL operative position has been developed from the initial prone posi-tion to supine and lateral positions.Various modified PCNL operative positions were also improved.The feasi-bility and safety of prone,supine and lateral positions of PCNL have been proved.The antegrade nephroscopic and retrograde ureteroscopic procedures could be performed simultaneously from modified operative positions , which has improved the stone removal efficiency .The deep understanding of puncture characteristics of differ-ent PCNL operative positions can promote the selection of proper position and facilitate further PCNL position modification.