Abstract: ［Abstract］ Objective To explore and compare the efficacy of tubeless percutaneous nephrolithotomy （PCNL） and ureteroscopic lithotripsy （URL） in the treatment of upper urinary calculi. Methods From February 2017 to March 2019， 60 cases of upper urinary tract calculi in our hospital were divided into PCNL group and URL group according to different surgical schemes， 30 cases each. The operation related indexes （operation time， phase I stone clearance rate， hemoglobin reduction， indwelling time of urinary catheter and hospitalization time）， postoperative pain degree， use rate of analgesics and incidence of postoperative complications were compared between the two groups. Results There was no significant difference in operation time， hemoglobin reduction， indwelling time of urinary catheter and hospitalization time between the two groups （P>0.05）|the stone clearance rate of stage I in PCNL group was higher than that in URL group （P<0.05）|the pain score and the use rate of analgesics in PCNL group were no significant difference compared with that in URL group （P>0.05）|there was no significant difference in the incidence of postoperative complications between the two groups （P>0.05）. Conclusion Compared with URL， PCNL without cannulated microchannel has a higher clearance rate of upper urinary tract calculi in stage I. It can effectively reduce the degree of pain and the use of analgesics， reduce the occurrence of complications， shorten the indwelling time of urinary catheter， and promote the recovery of patients. It is worthy of clinical promotion and application.

Key words: ureteroscopic lithotripsy, upper urinary calculi, non?tubular microchannel percutaneous nephrolithotomy

摘要： ［摘要］ 目的 探究对比无管化微通道经皮肾镜取石（PCNL）与输尿管镜碎石（URL）治疗上尿路结石的效果。方法 选取2017年2月～2019年3月我院60例上尿路结石作为研究对象，依据手术方案不同分为PCNL组与URL组，各30例。统计对比两组手术相关指标（手术用时、Ⅰ期结石清除率、血红蛋白减少量、尿管留置时间及住院时间）、术后疼痛程度、镇痛药物使用率及术后并发症发生率。结果 两组手术用时、术后血红蛋白减少量、尿管留置时间及住院时间相比，无明显差异（P>0.05）；PCNL组I期结石清除率较URL组高（P<0.05）；PCNL组术后疼痛评分、镇痛药物使用率与URL组相比，均无明显差异（P>0.05）两组术后并发症发生率相比，无明显差异（P>0.05）。结论 相较于URL，无管化微通道PCNL治疗对上尿路结石患者，I期结石清除率较高，不会增加患者术后疼痛程度、镇痛药物使用率及术后并发症发生率，且未延长术后尿管留置时间。

关键词: 输尿管镜碎石, 无管化微通道经皮肾镜取石术, 上尿路结石