CAJ | 학술논문

目的：探讨输尿管镜联合 U －100激光碎石治疗婴幼儿输尿管结石的可行性和临床效果。方法回顾性分析2012年6月至2014年8月采用经尿道输尿管镜U－100激光碎石术治疗57例64侧婴幼儿输尿管结石的临床资料。男39例，女18例，年龄6～36个月，平均（11±6）个月，婴儿24例，幼儿33例。输尿管中下段结石26例，输尿管上段结石15例，输尿管结石并肾结石7例，双侧输尿管结石9例，结石直径9～24 mm，平均（14±1．9） mm。结果Ⅰ期输尿管镜成功碎石41例46侧，12例逆行置入输尿管支架管引流Ⅱ期手术，双侧置管4例，单侧置管8例，4例改行经皮肾镜取石术。平均手术时间（46±8）min，平均住院时间（9．2±1．6） d，1例术中出现输尿管上段穿孔，5例（8．7％）术后发热（≥38．5℃）。术后留置双 J管4周，拔管前复查泌尿系B超或KUB，一期结石清除率84．2％（48／57）。57例随访3～26个月，平均18个月，未见输尿管狭窄、结石复发。结论对于输尿管镜技术成熟的医院，选择合适的输尿管镜，联合 U －100激光碎石处理婴幼儿输尿管结石安全可行，疗效好。
목적：탐토수뇨관경연합 U －100격광쇄석치료영유인수뇨관결석적가행성화림상효과。방법회고성분석2012년6월지2014년8월채용경뇨도수뇨관경U－100격광쇄석술치료57례64측영유인수뇨관결석적림상자료。남39례，녀18례，년령6～36개월，평균（11±6）개월，영인24례，유인33례。수뇨관중하단결석26례，수뇨관상단결석15례，수뇨관결석병신결석7례，쌍측수뇨관결석9례，결석직경9～24 mm，평균（14±1．9） mm。결과Ⅰ기수뇨관경성공쇄석41례46측，12례역행치입수뇨관지가관인류Ⅱ기수술，쌍측치관4례，단측치관8례，4례개행경피신경취석술。평균수술시간（46±8）min，평균주원시간（9．2±1．6） d，1례술중출현수뇨관상단천공，5례（8．7％）술후발열（≥38．5℃）。술후류치쌍 J관4주，발관전복사비뇨계B초혹KUB，일기결석청제솔84．2％（48／57）。57례수방3～26개월，평균18개월，미견수뇨관협착、결석복발。결론대우수뇨관경기술성숙적의원，선택합괄적수뇨관경，연합 U －100격광쇄석처리영유인수뇨관결석안전가행，료효호。
Objectives To evaluate the clinical efficacy and feasibility of FREDDY laser lithotripsy for the treatment of ureteral calculi in infants.Methods Retrospectively analyse 57 cases(64 sides) of children with ure-teral calculi and treated by ureteroscopic FREDDY laser lithotripsy between June 2012~August 2014.The male 39 cases,female 18 cases,aged 6~36 months,the average(11 ±6)months,24 cases of infants,33 cases of toddlers.In all patients,26 cases of middle and lower ureteral calculi,15 cases of upper ureteral calculi,7 cases of ureteral calculi combined kidney calculi,9 cases of bilateral ureteral calculi.The diameter of the calculi was 9~24 mm,average(14 ±1.9) mm.Results A total of 41 cases(46 sides) had successfully underwent one stage ureteroscopic FREDDY laser lithotripsy,12 patients underwent retrograde ureteral stent drainage under ureteroscope,4 cases were bilateral,8 cases of unilateral,4 cases needed a change to percutaneous nephrolithotomy.The average operation time was (46 ± 8) min,the mean hospital stay was (9.2 ±1.6) days.The complications included 1 case of perforation in the upper ureteral,5 cases(8.7%) of postoperative fever (≥38.5 ℃).All patients had indwelling double J catheter for 4 weeks.Review of the urinary tract ultrasound or KUB before double J stent removal,the stone clearance rate was 84. 2%(48/57).The mean follow-up duration was 18 months(range,3-26 months),no ureteric stenosis and stone re-currence was seen.Conclusions Ureteroscopy combined FREDDY laser lithotripsy is an effective and minimally invasive treatment of infant with ureteral calculi .