【摘要】目的 分析微创经皮肾取石术（mPCNL）联合钬激光碎石治疗复杂性肾结石的疗效及并发症。方法 将320例复杂性肾结石患者随机分为A组和B组，各160例，分别采用mPCNL联合钬激光碎石取石术、开放性肾切开取石术进行治疗，比较分析两组手术相关指标、结石清除率、术后疼痛程度及并发症情况。结果 与B组比较，A组的手术时间、术后下床活动时间及住院时间明显缩短，术中出血量减少（P<0.05）；A组结石的清除率为92.5%，显著高于B组80.6%（P<0.05）；A组患者术后的Ⅱ、Ⅲ级疼痛程度占20.6%，显著低于B组38.1%（P<0.05）；A组出血、切口感染、尿瘘及肾绞痛的发生率显著均低于B组（P<0.05）。结论 MPCNL钬激光碎石治疗复杂性肾结石，可有效缩短手术时间，减轻术后疼痛，减少并发症，提高结石清除率。

Abstract Objective：To explore the clinical effect and complications of minimally percutaneous nephrolithotomy(mPCNL) with holmium laser on the treatment of complex nephritic stone. Methods：320 patients with complex nephritic stone were treated by mPCNL with holmium laser (Group A, n=160) and open renal lithotomy(Group B, n=160). The operation related indicators, stone clearance rate, degree of postoperative pain and complications between two groups were comparatively analyzed. Result：Compared with Group B, group A, the operation time, postoperative activity time and hospitalization time in Group A were significantly shortened, the intraoperative blood loss was also reduced(P<0.05). The stone clearance rate in Group A were 92.5% and 80.6% in Group B , respectively (P<0.05). The proportion of Ⅱ,Ⅲ pain was 20.6% in Group A, which was significantly lower than 38.1% in Group B(P<0.05). The incidence of bleeding, incision infection, urinary fistula and renal colic in Group A were significantly lower than those in Group B(P<0.05). Conclusions: mPCNL with holmium laser for the treatment of complex nephritic stone can effectively shorten the operation time, reduce postoperative pain and complications, improve the stone clearance rate.