经尿道输尿管镜碎石联合膀胱微穿刺引流治疗小儿下尿路结石  

Clinical Study of Transurethral Bladder Micro URSL Joint Puncture and Drainage Treatment for Pediatric Calculus of Lower Urinary Tract

作　　者：马贵斌 孙琼 何昊阳 李立宇 陶志兴 王卫生 

机构地区：[1]曲靖市第二人民医院泌尿外科,云南曲靖655000

出　　处：《昆明医科大学学报》2013年第9期120-122,共3页Journal of Kunming Medical University

摘　　要：目的探讨经尿道输尿管镜碎石联合膀胱微穿刺引流治疗小儿下尿路结石的临床疗效.方法 2003年1月至2013年1月期间,曲靖市第二人民医院收治的小儿下尿路结石66例,随机分成观察组和对照组,每组33例;观察组采用经尿道输尿管镜碎石联合膀胱微穿刺引流方法治疗,对照组采用单纯经尿道输尿管镜碎石方法治疗.观察和记录手术时间、术后尿色转清时间、拔尿管后结石排净时间、术后住院时间、术后尿道狭窄发生例数等并进行组间比较.结果 2组手术都顺利完成,对照组平均手术时间(30.2±2.4)min,术后尿色转清时间(2.5±0.5)d,拔出尿管后结石排净时间(2.1±0.8)d,术后住院时间(4.0±0.5)d,术后随访1 a尿道狭窄1例,观察组手术时间(20.3±2.3)min,术后尿色转清时间(1.5±0.7)d,拔出尿管后结石排净时间(1.1±0.2)d,术后住院时间(3.1±0.3)d,术后随访1 a尿道狭窄0例,显著低于对照组(P<0.05).结论经尿道输尿管镜碎石联合膀胱微穿刺引流与经尿道输尿管镜碎石治疗小儿下尿路结石相比具有更好的有效性及安全性,可缩短手术时间、术后尿色转清时间、拔出尿管后碎石排出时间、术后平均住院时间,降低术后继发尿道狭窄发生率.Objective To investigate the clinical efficacy of the urethra URSL combined with micro-puncture and drainage treatment for pediatric calculus of lower urinary tract. Methods From January 2003 to January 2013, 66 cases with pediatric urinary tract calculi in our hospital were randomly equally divided into experimental group and control group. The experimental group was treated with transurethral bladder micro URSL combined puncture and drainage treatment, and the control group was given a simple transurethral URSL method of treatment. The operative time, postoperative urine turned clear time, pulling stone clearance after catheter time, postoperative hospital stay and the incidence of postoperative urethral stricture were observed and recorded. In addition, these data were compared between the two groups. Results The operations of two groups have successfully completed. The mean operative time, postoperative urine turned clear time, pull out the catheter stone clearance after time and postoperative hospital stay of control group was 30.2 ± 2.45 minutes, 2.5 ± 0.5 days, 2.1 ± 0.8 days and 4.0 ± 0. 5 days, respectively. Patients were followed up 1 year after operation, and 1 case of urethral stricture occurred. However, the mean operative time, postoperative urine turned clear time, pull out the catheter stone clearance after time and postoperative hospital stay of the test group was 20.36 ± 2.35 minutes, 1.5 ± 0.7 days, I.I ± 0.25 days and 3.1 ± 0.3 days, respectively, with no urethral stricture case occurred. There were significant differences between the two groups （P〈0.05） Conclusion Transurethral bladder URSL micro puncture and drainage combined withtransurethral ureteroscopy lithotripsy treatment for children with lower urinary tract calculi has better efficacy and safety. It could shorter operative time, postoperative urine turned clear time, the gravel discharge time and average hospitalization time, reduce the incidence of postoperative secondary urethral stricture.

关 键 词：小儿下尿路结石 经尿道 膀胱微穿刺引流 输尿管镜碎石 疗效 

分 类 号：R693.4[医药卫生—泌尿科学]