摘要目的: 评价Y型扩张引流鞘在部分无管化微通道经皮肾镜碎石取石术（PCNL）治疗上尿路结石中的临床价值。方法: 回顾性分析2019年1月至2021年12月福建医科大学附属泉州第一医院泌尿外科同一手术团队完成的部分无管化微通道PCNL患者276例,分为研究组和对照组,每组138例。研究组采用Y型扩张引流鞘,对照组采用普通经皮肾镜外鞘。比较两组一般资料、手术相关指标及并发症等。结果: 研究组相比对照组手术时间短[（62.6±15.8） vs. （94.4±17.3）min],一期结石清除率高[96.37%（133/138） vs. 78.26%（108/138）],术中肾盂内压力低[（8.36±1.58） vs. （19.74±2.62）mmHg],术后4 d发热[4.3%（6/138） vs. 10.9%（15/138）]和尿源性脓毒血症发生率低[0.72%（1/138） vs. 5.80%（8/138）],差异具有统计学意义（P<0.05）。结论: Y型扩张引流鞘在部分无管化微通道PCNL中具有临床应用价值。
Abstract：Objective: To evaluate the clinical value of Y-shaped expansion-drainage sheath in the treatment of upper urinary tract calculi by partial tubeless minimally invasive percutaneous nephrolithotomy （PCNL）. Methods: From January 2019 to December 2021, 276 patients with partial tubeless minimally invasive PCNL completed by the same surgical team in the Department of Urology, Quanzhou First Hospital, Fujian Medical University were retrospectively analyzed. They were divided into study group and control group, with 138 patients in each group. The study group was given Y-shaped expansion-drainage sheath, and the control group was subjected to common percutaneous nephroscope outer sheath. The general data, operation-related indexes and complications of the two groups were compared. Results: The study group had shorter operation time[（62.6±15.8） vs.（94.4±17.3）min], higher primary stone clearance rate [96.37%（133/138） vs. 78.26%（108/138）], and lower intrapelvic pressure during operation [（8.36±1.58） vs. （19.74±2.62）mmHg] than in the control group. The incidence of fever [4.3% （6/138） vs. 10.9%（15/138）] and urinary sepsis [0.72% （1/138） vs. 5.80%（8/138）] was low at 4 days after surgery in the study group and control group respectively, with statistically significant differences （P<0.05）. Conclusion: Y-shaped expansion-drainage sheath has clinical application value in partially tubeless minimally invasive PCNL.
