摘要
目的探讨经皮肾镜取石术(PCNL)治疗儿童上尿路结石的疗效和安全性。方法回顾性分析2008年3月—2011年4月被确诊为上尿路结石并接受PCNL治疗的20例患儿的临床资料,其中单侧肾结石10例,双肾结石8例,左输尿管上段结石1例,左输尿管上段结石合并双肾结石1例。结石直径10～40 mm。术前均经B超、CT平扫+三维重建检查明确诊断,静脉肾盂造影检查判断有无输尿管梗阻。结果 20例患儿共26侧肾接受PCNL治疗。平均手术时间为(35±14)min,术中平均出血量为(30±5)ml。术后全部留置肾造瘘管,2～5 d后拔除,患侧留置双J管,2周后在膀胱镜下拔除。术后住院时间为2～6 d,从静脉途径给予抗生素治疗3～5 d。术后随访6个月,患儿生长发育良好。复查B超,15例患儿肾和输尿管未发现结石,无复发,肾盂积水消失或减轻;4例有结石残留;1例复发。结论 PCNL治疗儿童上尿路结石是一种安全、有效的方法,具有结石清除率高、创伤小、恢复快、住院时间短的优点。
Objective To evaluate the clinical efficacy and safety of percutaneous nephrolithotomy （PCNL） in the treatment of upper urinary tract calculi in children. Methods Clinical data of 20 cases with upper urinary tract calculi from March 2008 to April 2011 were retrospectively reviewed. Among the patients, single - side renal calculi was found in 10 cases, bilateral renal calculi was found in 8 cases, left - side upper ureteral calculi was found in 1 case, and left - side upper ureteral calculi combined with bilateral renal stones was found in 1 case. The diameters of these stones were ranging from 10 -40 mm, and 8 ca- ses had staghorn stones. All the urinary calculi were confirmed by B ultrasound examination and spiral CT scanning. IVU （ intrave- nous urography） was used to evaluate the extent of ureter obstruction. Results 20 cases （26 sides） underwent PCNL The mean operative time was （35±14） minutes. The average volume of bleeding was （30±5 ） ml during operation. The nephrostomy tubes were left in all patients after operation and removed 2 to 5 days later. Ureteral Double - J - Stents were left in 20 patients and re- moved by cystoscope after two weeks. The postoperative hospital stays were 2 to 6 days. The antibiotic treatment was given via vein for 3 to 5 days. All cases were followed up for 6 months, and the growth and development of the children were fine. 15 patients＇ calculi completely disappeared with no recurrence, and hydronephrosis disappeared or was improved. Four cases still had residuals and one case had recurrence. Conclusion PCNL is an effective and safe treatment for renal or upper ureteral calculi in children with high stone -free rate, minimal invasion, shorter hospital stay and shorter recovery time.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第9期1049-1051,共3页
Chinese General Practice
关键词
肾造口术
经皮
肾结石
输尿管结石
Nephrostomy, percutaneous
Kidney calculi
Ureteral calculi
