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目的探讨体外震波碎石(ESWL)治疗儿童上尿路结石的安全性和疗效。方法采用ESWL治疗儿童上尿路结石300例,患儿年龄7个月～10岁,其中肾结石202例,输尿管结石98例。首次ESWL治疗后1周～3个月检查发现尿路梗阻或结石未排尽者再行ESWL治疗。首次ESWL治疗后3个月评定患者治疗效果。结果 202例肾结石患儿1次ESWL治愈169例(83.66%),2次ESWL治愈32例(15.84%),1例改行经皮肾镜碎石术治疗。98例输尿管结石患儿1次ESWL治愈84例(85.71%),2次ESWL治愈13例(13.27%),1例改行输尿管镜钬激光碎石术治疗。首次ESWL治疗后3个月肾、输尿管结石治愈率分别为94.55%和98.98%,所有患儿均无严重并发症发生。结论 ESWL是治疗儿童上尿路结石安全、有效的方法。
Objective To investigate the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) in children with upper urinary tract calculi. Methods Three hundred children with upper urinary tract stones were treated with ESWL. The children were 7 months to 10 years old, including 202 cases of kidney stones and 98 cases of ureteral stones. The first ESWL treatment after 1 week to 3 months examination found that urinary tract obstruction or stones were not exhausted who ESWL treatment. Three months after the first ESWL treatment, the treatment effect was evaluated. Results One hundred and two children with nephrolithiasis were cured by one ESWL in 169 cases (83.66%), two were cured by ESWL in 32 cases (15.84%), and one was treated by percutaneous nephrolithotomy. A total of 98 cases of ureteral calculi were treated with one ESWL cure in 84 cases (85.71%), two cases of ESWL were cured in 13 cases (13.27%), and one case was treated by ureteroscopic holmium laser lithotripsy. Three months after the first ESWL treatment, the cure rates of kidney and ureteral calculi were 94.55% and 98.98%, respectively. No serious complication occurred in all children. Conclusion ESWL is a safe and effective method for treating upper urinary tract stones in children.