CAJ | 학술논문

目的：探讨微创经皮肾镜取石术（MPCNL）治疗儿童上尿路结石的有效性和安全性。方法回顾性分析2004年1月-2013年4月收治的经微创经皮肾镜取石术（气压弹道联合钬激光）治疗39例43侧上尿路结石患儿。输尿管镜下患侧输尿管逆行留置4～6F输尿管导管，B型超声引导下穿刺目标肾盏建立皮肾通道，气压弹道联合钬激光碎石，术后复查X线片或B型超声评价结石排出情况。结果所有病例均一期成功建立经皮肾通道并处理结石。手术时间50～143（82湝．0±9．0）min，结石清除率90．7％（39/43）。术中无气胸、邻近脏器损伤等严重并发症发生。37例术后随访3～12个月，患儿肾积水均未加重，肾功能较术前改善，亦没有远期并发症的发生。结论微创经皮肾镜取石术具有创伤小、并发症少、结石清除率高等优点，治疗儿童上尿路结石安全、可靠。
목적：탐토미창경피신경취석술（MPCNL）치료인동상뇨로결석적유효성화안전성。방법회고성분석2004년1월-2013년4월수치적경미창경피신경취석술（기압탄도연합화격광）치료39례43측상뇨로결석환인。수뇨관경하환측수뇨관역행류치4～6F수뇨관도관，B형초성인도하천자목표신잔건립피신통도，기압탄도연합화격광쇄석，술후복사X선편혹B형초성평개결석배출정황。결과소유병례균일기성공건립경피신통도병처리결석。수술시간50～143（82개．0±9．0）min，결석청제솔90．7％（39/43）。술중무기흉、린근장기손상등엄중병발증발생。37례술후수방3～12개월，환인신적수균미가중，신공능교술전개선，역몰유원기병발증적발생。결론미창경피신경취석술구유창상소、병발증소、결석청제솔고등우점，치료인동상뇨로결석안전、가고。
Objective To investigate the effect and safety of minimally invasive percutaneous nephrolithotomy ( MPC-NL) in treatment of upper urinary tract calculi in children .Methods Retrospecitvely analyzed 39 cases(43 sides) with upper urinary tract calculi from January 2004 to April 2013 ,they were all received minimally invasive percutaneous nephrolithotomy with pneumatic lithotripsy(pneumatic lithotripsy and holmium laser ).Under the ipsilateral ureter retrograde ureteroscopy 4-6F indwelling ureteral catheter , puncture percutaneous renal target calyx established channels under B -type ultrasound guidance , pneumatic lithotripsy and holmium laser lithotripsy , X-ray films or B-type ultrasound were used to evaluate stone expulsion af-ter operation .Results One session MPCNL were successfully performed in all children .The operation time ranged from 50 to 143 (82.0 ±9.0) min, the stone clearance rate was 90.7%(39/43).Severe complications such as pneumothorax ,intraope-rative injury to adjacent organs did not occurred in all patients .Thirty-seven patients were followed up for 3-12 months,chil-dren with hydronephrosis were not aggravated , the kidney function is improved after operation , no complications occurred . Conclusion Minimally invasive percutaneous nephrolithotomy with fewer traumas , less complications , the stone clearance rate was high;it is safe and reliable to treat upper urinary tract calculi in children .