经皮膀胱输尿管镜弹道碎石治疗男性小儿尿道膀胱结石的疗效观察  

Feasibility and Clinical Efficacy of Percutaneous Ureteroscopic Lithotripsy in the Treatment of Male Children with Urinary Tract Stones and Bladder Stones

作　　者：李柏均 

机构地区：[1]广西桂东人民医院泌尿外科,广西桂东543001

出　　处：《医学综述》2011年第8期1272-1273,共2页Medical Recapitulate

摘　　要：目的评估经皮膀胱输尿管镜弹道碎石治疗男性小儿尿道膀胱结石的可行性及临床疗效。方法采用德国WOLF F8/9.8输尿管硬镜、广州医学院第一附属医院的APL-2型气压弹道碎石机,对选取的40例男性小儿尿道膀胱结石患儿行经皮膀胱输尿管镜气压弹道碎石治疗,其中8例为后尿道结石,32例为膀胱结石。结果所有患儿均一次性碎石治疗成功,结石清除率100%,碎石时间为(30.0±2.5)min,术后血尿1～3 d,平均1.6 d,留置造瘘管5～7 d,住院5～8 d,平均6 d。术后发热6例,经对症治疗后痊愈,膀胱刺激征3例,药物治疗好转,术后复查B超及X线提示无结石残留,无大出血、感染、穿孔及尿道狭窄、尿瘘等并发症,随访3～20个月无结石复发。结论经皮膀胱输尿管镜弹道碎石术治疗男性小儿尿道膀胱结石安全高效且碎石确切,值得临床推广应用。Objective To evaluate the feasibility and clinical efficacy of percutaneous ureteroscopic lithotripsy in the treatment of male children with urinary tract stones and bladder stones.Methods German rigid WOLF F8/9.8 ureteroscopy and APL-2 pneumatic lithotripsy system were used for percutaneous ureteroscopic lithotripsy in 40 male children with urinary bladder stones（n of posterior urethral stones = 8;n of bladder stone = 32）.Results All the patients successfully completed lithotripsy in single attempt at an elimination rate of 100%.The time length of procedure was（30.0± 2.5）min.Postoperative hematuria was present for 1 ～3 d（mean,1.6 d）.Pelvic drain was maintained for 5 ～7 d and patients were hospitalized for 5 ～8 d（mean,6 d） postoperatively.Postoperative pyrexia occurred in 6 patients but resolved with symptomatic treatment.Three patients complained of bladder irritation and recovered with drug treatment.Follow-up ultrasonography and radiography identified no residual stone,overt bleeding,infection,perforation,urethral stenosis,or fistula.No stone relapsed during a follow-up period of 3 to 20 months.Conclusion Percutaneous ureteroscopic lithotripsy is safe and effective for the treatment of male children with urinary bladder stones,with an accurate lithotripsy effect and worthy of wide use.

关 键 词：输尿管镜 弹道碎石 男性小儿 尿道膀胱结石 

分 类 号：R691.4[医药卫生—泌尿科学]