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目的 总结小儿微创经皮肾输尿管镜取石术的临床疗效和安全性。方法 回顾性分析57例(59例次)应用微创经皮肾输尿管镜取石术治疗小儿上尿路结石的患儿资料。男34 例,女23例;年龄4~16岁。手术指征包括直径大于2.0cm或铸型肾结石36 例次(其中手术后残留或复发的肾结石9例次),引起梗阻性肾扩张的肾或输尿管上段结石9 例次,ESWL术失败的肾或输尿管上段结石7例次,合并远端梗阻的肾结石7例次。结果 手术治疗59例次,其中41例次(69.5%)经一次PCNL结石被完全清除。因术中出血需输血4 例次,明显尿外渗1 例次。PCNL加ESWL或重复PCNL,结石完全清除率达86.4%。结论 微创经皮肾输尿管镜取石术是一种治疗小儿肾和输尿管上段结石安全、有效的方法。
Objective To summarize the clinical efficacy and safety of minimally invasive percutaneous nephrolithotomy in children. Methods A retrospective analysis of 57 cases (59 cases) with minimally invasive percutaneous nephrolithotomy lithotripsy pediatric upper urinary tract stones in children. 34 males and 23 females; aged 4 to 16 years old. Surgical indications included 36 cases of diameter more than 2.0cm or mold kidney stones (9 cases of residual or recurrent renal stones after operation), 9 cases of renal or ureteral stones causing obstructive renal dilatation, ESWL failed Kidney or upper ureteral calculi in 7 cases, with distal obstruction of renal stones in 7 cases. Results Surgical treatment of 59 cases, of which 41 cases (69.5%) were completely cleared by a PCNL stone. Blood transfusion due to intraoperative blood transfusion in 4 cases, obviously 1 case of extravasation of urine. PCNL plus ESWL or repeated PCNL, complete removal of stones was 86.4%. Conclusion Minimally invasive percutaneous nephrolithotomy is a safe and effective method for the treatment of pediatric renal and upper ureteral calculi.