关键词: 经皮肾镜取石, B 超定位, 一步扩张法, 经皮肾通道扩张

Abstract: ［Abstract］ Objective To explore the safety and effectiveness of establishing a percutaneous renal access by one?step expansion. Methods 368 cases who underwent percutaneous nephrolithotomy from January 2014 to October 2017 in our hospital were retrospectively analyzed. According to the different ways of channel establishment, 188 cases were treated by F6?F18 fascia dilator for standard tract percutaneous nephrolithotomy procedure（control group）, and another 180 cases were treated by F18 or F20 fascia dilator by one?step renal access establishment （one?step group）. The establishment time of channel, operation time, blood loss, average length of stay, complications, one?time rate of clear stone were recorded in two groups and were compared between the two groups. Results 368 patients were successfully established channel to complete the operation. The patients in one?step expansion group had shorter establishment time of the channel, higher primary stone clearance rate, less bleeding, as compared to those in control group（all P values were less than 0.05）. There was no significant differences in average length of stay and complication between the two groups （P>0.05）. Conclusion One?step expansion method to establish percutaneous renal access to the treatment of upper urinary tract stones is safe and reliable, which can significantly shorten the non?lithotripsy time of the surgical procedure, and increase the one?time clear stone ratio.

Key words: percutaneous nephrolithotomy, B?positioning, one?step expansion, percutaneous renal access expansion