微创经皮肾穿刺U100plus激光和钬激光碎石术治疗肾结石的比较

Comparison of minimally invasive percutaneous nephrolithotomy with U100plus laser and holmium laser for renal calculi

目的评价采用微创经皮肾穿刺U100plus激光及钬激光碎石术治疗肾结石的安全性及有效性。方法北京友谊医院自2005年10月至2010年5月使用Wolf 8/9.8硬性输尿管镜联合U100plus激光和钬激光,采用微创经皮肾穿刺碎石术治疗肾结石277例。其中U100plus激光组129例,钬激光组148例。结果 277例一次穿刺成功。U100plus激光组一次取净结石106例,手术结石取净率82.5%;手术时间(102.8±34.2)min,术后住院时间(5.4±1.2)d。钬激光组一次取净结石124例,手术结石取净率83.9%;手术时间(98.6±30.7)min,术后住院时间(5.9±1.7)d。结论 U100plus激光和钬激光碎石术是治疗肾结石安全、有效的方法。U100plus激光对泌尿道黏膜无损伤,初学者易掌握。而对于胱氨酸等特殊类型结石而言,钬激光碎石优势更明显。

Objootive To evaluate the safety and feasibility of minimally invasive percutaneous nephrolithotomy （MPCNL） with U100plus laser and holmium laser for the treatment of renal calculi. Methods From Oct. 2005 to May 2010, MPCNL with Wolf8/9.8 rigid ureteroscope was performed on 277 patients suffering from renal calculi, including 129 cases treated with U100plus laser and 148 eases treated with holmium laser. Results MPCNL was completed in all 277 cases. In the U100plus laser group, 106 cases had stones completely cleared, the total stone clearance being 82.5%, the operation time （102. 8±34.2）rain, and mean postoperative hospital stay （5.4 ± 1.2）d. In the holmium laser group, 124 cases had stones completely moved, the total stone clearance being 83.9 %, the operation time （98. 6 5±30. 7）rain, and the mean postoperative hospital stay （5.9± 1.7）d. Oonclusions MPCNL with U100plus laser and holmium laser can safely and effectively treat patients with renal calculi.. U100plus Laser has no harm on urinary tract mucosa and is easy for beginners to operate. But for some special calculi, such as cystine stones, holmium laser is more effective.