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目的评估微创经皮肾镜取石术(MPCNL)术后无管化治疗3岁以下婴幼儿肾结石的安全性和可行性。方法将自2009年9月至2012年9月收治的70例3岁以下婴幼儿肾结石患儿随机分为无管化组(35例)和标准组(35例)两组,比较两组间手术时间、血红蛋白下降值、输血率、术后并发症、住院时间等指标上的差异。结果两组平均年龄、结石直径、术前血红蛋白、术后血红蛋白下降、手术时间等指标无统计学差异:无管化组平均年龄19.5个月,标准组平均年龄为17.7个月;无管化组平均结石直径2.2 cm,标准组2.4 cm;无管化组术前平均血红蛋白值11.2 g/dl,标准组10.8 g/dl;标准组平均手术时间为55 min,无管化组为53 min;无管化组结石清除率97.8%,标准组94.3%;无管化组术后血红蛋白下降(0.9±0.1)g/dl,标准组(0.8±0.2)g/dl;无管化组术后发热5.7%,标准组8.6%。但无管化组的住院时间明显少于标准组(4.7 d vs 7.8 d,P<0.001)。结论 MPCNL术后无管化治疗3岁以下婴幼儿肾结石具有恢复快,住院时间短等优点,是安全可行的。
Objective To evaluate the safety and feasibility of the management of minimally invasive percutaneous nephrolithotomy (MPCNL) for the management of kidney stones in infants under 3 years of age. Methods From September 2009 to September 2012, 70 infants with kidney stones under 3 years of age were randomly divided into two groups: control group (35 cases) and standard group (35 cases) Operation time, hemoglobin decline, blood transfusion rate, postoperative complications, hospital stay and other indicators of the differences. Results There was no significant difference in average age, diameter of stone, preoperative hemoglobin, postoperative hemoglobin, operation time and other indicators: the mean age of the control group was 19.5 months, the average age of the standard group was 17.7 months; The average diameter of stones was 2.2 cm in the standard group and 2.4 cm in the standard group. The average preoperative hemoglobin value was 11.2 g / dl in the control group, 10.8 g / dl in the standard group, 55 minutes in the standard group and 53 minutes in the control group. In the control group, the stone clearance rate was 97.8% in the standard group and 94.3% in the standard group. The hemoglobin level in the control group was (0.9 ± 0.1) g / dl less than that in the standard group (0.8 ± 0.2) g / dl and 5.7 %, Standard group 8.6%. However, the duration of hospital stay in the control group was significantly less than that in the standard group (4.7 days vs 7.8 days, P <0.001). Conclusions The management of renal stones under the age of 3 years with MPCNL after tubeless management has the advantages of quick recovery and short hospital stay, which is safe and feasible.