微创经皮肾穿刺U100plus激光碎石术治疗133例肾结石的临床体会

Minimally invasive percutaneous nephrolithotomy with U100plus laser for renal calculi：report of 133 cases

目的探讨采用微创经皮肾穿刺U100plus激光碎石术治疗肾结石的安全性及有效性。方法首都医科大学附属北京友谊医院自2006年10月～2008年12月使用Wolf8／9．8硬性输尿管镜联合U100plus激光，采用微创经皮肾穿刺碎石术治疗肾结石133例。结果133例一次性穿刺成功。一次性取净结石121例，7例患者术后复查残存肾内结石碎粒，口服排石药物，1个月后复查结石大部分排空，少量残留。5例患者于术后结合体外碎石（ESWL）排净结石，手术结石取净率为91．0％。手术时间38～65min，平均46min，术后肾造瘘管留置1～2d，术后住院2—4d。结论微创经皮肾穿刺U100plus激光碎石术是治疗肾结石的一种安全、有效的方法。

Objective To evaluate the safety and feasibility of minimally invasive percutaneous nephro- lithotomy （mPCNL） with U100plus laser for the treatment of renal calculi. Methods From October 2006 to December 2008 ,mPCNL was performed on 133 patients suffering from renal calculi by using Wolf 8/9. 8 rigid ureteroscope and UlOOplus laser. Results mPCNL was completed in all the 133 cases. Residual calculi were found in 7 cases after operation and use medical drags to treat. The most residual calculi were removed after 1 month and a few stones being survived. 5 cases with residual calculi were treated by ESWL. The total stone clearance was 91.0%. The operation time was 38 -65 min （mean 46 min）. Nephrostomy tube was kept for a mean of 1 -2 d. The mean postoperational hospital stay was 2 -4 d. Among the patients, 133 were followed up for 1-16 months （mean 8.3 months）, during which no recurrent renal stones were found by B ultrasonography or X ray. Conclusion By using mPCNL with U100plus laser, patients with renal calculi can be treated safely and effectively.