中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2010年
3期
172-174
,共3页
张伟%马文强%李文辉%梁军%张永革%闫红英%陈晓红%郎晓玲
張偉%馬文彊%李文輝%樑軍%張永革%閆紅英%陳曉紅%郎曉玲
장위%마문강%리문휘%량군%장영혁%염홍영%진효홍%랑효령
肾结石%肾造口术,经皮
腎結石%腎造口術,經皮
신결석%신조구술,경피
Kidney calculi%Nephrostomy,percutaneous
目的 探讨微创经皮肾镜取石术(MPCNL)治疗幼儿肾结石的手术技巧. 方法 12例肾结石患儿行MPCNL.男8例,女4例.平均年龄32(18~53)个月.12例均经KUB、IVU、B超和CT检查确诊.结石直径平均1.3(1.0~1.8)cm.单纯肾盂结石7例,合并多发性肾盏结石5例.无合并肾盂输尿管连接处狭窄者.均实施全麻,B超引导下穿刺目标肾盏,成功建立12~16 F皮肾通道并用气压弹道碎石机碎石. 结果 12例平均手术时间74 min.均Ⅰ期完成碎石,Ⅰ期结石清除率67%(8/12).1例残留结石直径>6 mm者行二次MPCNL后结石完全清除,总结石清除率75%(9/12).3例残留结石直径2~4 mm,其中1例术后2周行ESWL.术后平均住院时间14(10~42)d.随访1~7个月,结石清除率100%. 结论 MPCNL具有出血少、结石清除率高、住院时间短等优点,可作为治疗幼儿肾结石安全、有效的方法.
目的 探討微創經皮腎鏡取石術(MPCNL)治療幼兒腎結石的手術技巧. 方法 12例腎結石患兒行MPCNL.男8例,女4例.平均年齡32(18~53)箇月.12例均經KUB、IVU、B超和CT檢查確診.結石直徑平均1.3(1.0~1.8)cm.單純腎盂結石7例,閤併多髮性腎盞結石5例.無閤併腎盂輸尿管連接處狹窄者.均實施全痳,B超引導下穿刺目標腎盞,成功建立12~16 F皮腎通道併用氣壓彈道碎石機碎石. 結果 12例平均手術時間74 min.均Ⅰ期完成碎石,Ⅰ期結石清除率67%(8/12).1例殘留結石直徑>6 mm者行二次MPCNL後結石完全清除,總結石清除率75%(9/12).3例殘留結石直徑2~4 mm,其中1例術後2週行ESWL.術後平均住院時間14(10~42)d.隨訪1~7箇月,結石清除率100%. 結論 MPCNL具有齣血少、結石清除率高、住院時間短等優點,可作為治療幼兒腎結石安全、有效的方法.
목적 탐토미창경피신경취석술(MPCNL)치료유인신결석적수술기교. 방법 12례신결석환인행MPCNL.남8례,녀4례.평균년령32(18~53)개월.12례균경KUB、IVU、B초화CT검사학진.결석직경평균1.3(1.0~1.8)cm.단순신우결석7례,합병다발성신잔결석5례.무합병신우수뇨관련접처협착자.균실시전마,B초인도하천자목표신잔,성공건립12~16 F피신통도병용기압탄도쇄석궤쇄석. 결과 12례평균수술시간74 min.균Ⅰ기완성쇄석,Ⅰ기결석청제솔67%(8/12).1례잔류결석직경>6 mm자행이차MPCNL후결석완전청제,총결석청제솔75%(9/12).3례잔류결석직경2~4 mm,기중1례술후2주행ESWL.술후평균주원시간14(10~42)d.수방1~7개월,결석청제솔100%. 결론 MPCNL구유출혈소、결석청제솔고、주원시간단등우점,가작위치료유인신결석안전、유효적방법.
Objective To evaluate the technique and efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL) for renal calculi in pediatric patients. Methods From April 2009 to December 2009, 12 pediatric patients (8 males and 4 females) with renal calculi were treated by MPCNL. The age ranged from 18 to 53 months (mean 32 months). All the 12 cases were diagnosed by KUB+IVU, ultrasonography and CT. The stone had average diameter of 1. 3 cm (ranged from 1. 0 to 1. 8 cm). Seven cases had simple renal pelvis stone and 5 cases had multiple renal calyx stone. UPJ stricture was not found in this series. General anaesthesia was applied. Renal transfixion pin was punctured to select renal calices by monitoring with ultrasonography. 12 - 16 F percutaneous renal access was successfully established in all cases and calculi were fragmented by pneumatic lithotripter. Results The average operative time of MPCNL was 74 min. Phase Ⅰ lithotripsy was underwent in all patients. The phase Ⅰ stone-free rate was 67%(8/12). One cases accepted second MPCNL. The calculus clearance rate reached 75%(9/12). Three cases had residual calculi ranged from 2 to 4 mm. One of whom had ESWL 2 weeks postoperatively. All cases were followed up for 1 - 7 months, all cases were in stone free status. Conclusion Regarding the advantages of less bleeding, high clearance rate, and shorter hospital stay, MPCNL is an effective and safe treatment option for renal calculi in pediatric patients.