关键词: 输尿管软镜, 复杂性肾结石, 疗效, 经皮肾镜碎石术

Abstract: ［Abstract］ Objective To evaluate the clinical efficacy of percutaneous nephrolithotomy （PCNL） combined with flexible ureteroscope on complex renal calculi in the elderly. Methods Eighty?eight elderly patients with complex renal calculi in our hospital from January 2015 to December 2016, were divided into control group and observation group in accordance with the admission number and even order, 44 cases in each group. The control group was given PCNL treatment, and the observation group were treated with PCNL combined with flexible ureteroscopic. The levels of serum urea nitrogen（SUN）, serum creatinine（ScR）, cystain C（CysC）, β2?MG, uric acid（UA）of the two groups were tested and compared. Serum norepinephrine（NE）, cortisol（Cor）and dopamine（DA）levels were measured preoperatively, postoperatively 6 h and postoperatively 24 h. The stone clearance rate, postoperative bleeding and infection complications were compared between the two groups. Results The stone clearance rates at postoperative 3 d and 30 d of the observation group were 93.94% , 97.73% , and both were significantly higher than those of the control group （P<0.05）. The levels of SUN, ScR, UA, β2?MG and CysC at postoperative 3 d and 30 d of the observation group were significantly lower than those of the control group （P<0.05）. The levels of NE, Cor, DA of the observation group at postoperative 6h and postoperative 24h were lower than those of the control group（P<0.05）. The length of stay and total complication rate of the observation group were 4.13 ± 1.28 d, 6.82% , and were also significantly lower than those of the control group （P<0.05）. Conclusion Compared with PCNL, percutaneous nephrolithotomy combined with flexible ureteroscopy has higher rate of stone removal, faster recovery of renal function and less complications in the treatment of complex renal calculi.

Key words: flexible ureteroscope, complex renal calculi, PCNL, curative effect