中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2013年
1期
34-37
,共4页
李九智%王雪怡%文彬%李建兴%王岩岗%宋超
李九智%王雪怡%文彬%李建興%王巖崗%宋超
리구지%왕설이%문빈%리건흥%왕암강%송초
肾造口术,经皮%输尿管结石%外科手术,微创性
腎造口術,經皮%輸尿管結石%外科手術,微創性
신조구술,경피%수뇨관결석%외과수술,미창성
Nephrostomy,percutaneous%Ureteral calculi%Surgical procedures,minimally invasive
目的 对彩色多普勒超声引导的mPCNL术治疗小儿输尿管中上段结石效能及安全性进行评估.方法 回顾性分析2006年1月至2011年10月间80例彩色多普勒超声引导的小儿mPCNL术,年龄7~60个月,平均32 76个月,左侧34例,右侧32例,双侧14例,共94侧.记录通道建立时间、手术时间、穿刺部位、净石率、术前术后血红蛋白变化及并发症情况.结果 手术均获成功,结石大小为ll~18mm,平均(11.9±3.2) mm.71侧肾均一期成功建立通道并处理结石,23侧肾二期取石,平均手术时间(36.4±7.5)min.净石率为100%.术后72.34%(68/94)的患儿出现血红蛋白和红细胞压积下降,血红蛋白平均下降6.72 g/L,红细胞压积平均下降2.13%.术后23例(28.75%)出现持续性或反复发热,无严重并发症发生.结论 彩超引导的mPCNL治疗小儿输尿管上段结石具有手术时间短,净石率高,并发症少等优点,是治疗小儿输尿管中上段结石的最佳选择.
目的 對綵色多普勒超聲引導的mPCNL術治療小兒輸尿管中上段結石效能及安全性進行評估.方法 迴顧性分析2006年1月至2011年10月間80例綵色多普勒超聲引導的小兒mPCNL術,年齡7~60箇月,平均32 76箇月,左側34例,右側32例,雙側14例,共94側.記錄通道建立時間、手術時間、穿刺部位、淨石率、術前術後血紅蛋白變化及併髮癥情況.結果 手術均穫成功,結石大小為ll~18mm,平均(11.9±3.2) mm.71側腎均一期成功建立通道併處理結石,23側腎二期取石,平均手術時間(36.4±7.5)min.淨石率為100%.術後72.34%(68/94)的患兒齣現血紅蛋白和紅細胞壓積下降,血紅蛋白平均下降6.72 g/L,紅細胞壓積平均下降2.13%.術後23例(28.75%)齣現持續性或反複髮熱,無嚴重併髮癥髮生.結論 綵超引導的mPCNL治療小兒輸尿管上段結石具有手術時間短,淨石率高,併髮癥少等優點,是治療小兒輸尿管中上段結石的最佳選擇.
목적 대채색다보륵초성인도적mPCNL술치료소인수뇨관중상단결석효능급안전성진행평고.방법 회고성분석2006년1월지2011년10월간80례채색다보륵초성인도적소인mPCNL술,년령7~60개월,평균32 76개월,좌측34례,우측32례,쌍측14례,공94측.기록통도건립시간、수술시간、천자부위、정석솔、술전술후혈홍단백변화급병발증정황.결과 수술균획성공,결석대소위ll~18mm,평균(11.9±3.2) mm.71측신균일기성공건립통도병처리결석,23측신이기취석,평균수술시간(36.4±7.5)min.정석솔위100%.술후72.34%(68/94)적환인출현혈홍단백화홍세포압적하강,혈홍단백평균하강6.72 g/L,홍세포압적평균하강2.13%.술후23례(28.75%)출현지속성혹반복발열,무엄중병발증발생.결론 채초인도적mPCNL치료소인수뇨관상단결석구유수술시간단,정석솔고,병발증소등우점,시치료소인수뇨관중상단결석적최가선택.
Objective To evaluated the safety and efficacy of mini percutaneous nephrolithotomy (mPCNL) under the guidance of ultrasonography for the management of upper and middle ureteral calculi in children below 5 years of age.Methods From January 2006 to October 2011,80 children underwent mPCNL under the guidance of ultrasonography to remove the upper and middle ureteral calculi.The mean age of the patients was 32.76 months old (range,7-60 months).The clinical data including time to establish renal access,operative time,puncture sites,stone-free rate and postoperative hemoglobin drop were retrospectively analyzed.Stone clearance was confirmed on X-radiography,ultrasonography or CT.Results The mean stone burden,defined as the largest diameter of the calculi,was 11.9 ± 3.2 mm (range,11-18 mm).mPCNL was successfully preformed on all patients.Of the 94 kidneys,71 were performed rnPCNL in one stage.The other 23 kidneys underwent percutaneous nephrotomy due to severe urinary infection,and were performed secondary mPCNL to remove calculi.The mean time to establish renal access was 9.7 ± 4.3 min.The mean operative time was 36.4 ±7.5 min.Superior and middle caliceal puncture was employed to establish access to 65 and 29 kidneys retrospectively.No lower caliceal puncture was used.All patients were stone free after mPNCL.Hemoglobin and hematocrit drop was noted in 72.34% (68/94)cases.The mean drop of Hemoglobin was 6.72 g/L,and mean hematocrit drop was 2.13%.Twenty three(28.75%)children were administered intravenous antibiotics for post-operative fever(≥38.5 ℃).No transfusion,kidney loss,collateral injury,sepsis shock and death were noted in this study.Conclusions Ultrasonography guided PCNL is safe and effective in the management of upper and middle ureteral stones in children.