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目的探讨经皮肾输尿管镜下气压弹道碎石术治疗儿童肾结石的疗效与安全性。方法肾结石患儿15例,均为14岁以下,其中单侧8例,双侧7例,共22个肾脏。全部病例使用全身麻醉下经皮肾输尿管镜下气压弹道碎石术治疗。术后行X线摄片观察疗效,术后48h查血红蛋白。所有病例均行代谢评估,术后使用枸橼酸钾预防结石复发。术后随访2~3年。结果20个肾脏(91%)的结石完全清除。2个有残石的肾脏经体外冲击波碎石术治疗,结石完全清除。14例患儿术后有轻、中度发热(<39℃,<2d),1例术后高热(>39℃,>2d)。患儿术后血红蛋白较术前平均下降10.0g/L。无输血病例。平均住院5.2d。全部病例术后半年行静脉肾盂造影检查,肾功能均平稳或有改善。无远期并发症。结论对儿童肾结石行经皮肾输尿管镜下气压弹道碎石术安全、有效。
Objective To investigate the efficacy and safety of percutaneous renal ureteroscopic pneumatic lithotripsy in the treatment of children with kidney stones. Methods 15 cases of children with kidney stones, both under 14 years old, including 8 cases of unilateral, bilateral in 7 cases, a total of 22 kidneys. All cases under general anesthesia with percutaneous renal ureteroscopic pneumatic lithotripsy treatment. Postoperative X-ray observation of curative effect, hemoglobin 48h after surgery. All patients underwent metabolic assessment, potassium citrate after surgery to prevent the recurrence of stones. Follow-up 2 to 3 years after operation. Results Tumors in 20 kidneys (91%) were completely eliminated. 2 with residual stone kidney by extracorporeal shock lithotripsy, stone completely removed. Fourteen patients had mild to moderate fever (<39 ℃, <2d) and one postoperative fever (> 39 ℃,> 2d). Children with postoperative hemoglobin decreased preoperative average 10.0g / L. No transfusion cases. Average hospitalization 5.2d. All cases of six months after intravenous pyelography, renal function were stable or improved. No long-term complications. Conclusion Percutaneous renal ureteroscopic pneumatic lithotripsy is safe and effective for children with kidney stones.