微创经皮肾镜取石术术后无管化治疗3岁以下婴幼儿肾结石的评价  

Tubeless minimally invasive percutaneous nephrolithotomy for infants under three years old with renal calcnl

作　　者：宋光鲁[1] 牛刚 拜合提亚.阿扎提 安尼瓦尔.牙生[1] 王玉杰[1] 

机构地区：[1]新疆医科大学第一附属医院泌尿外科,乌鲁木齐830054 [2]柯坪县医院泌尿外科,新疆阿克苏地区843600

出　　处：《中华腔镜泌尿外科杂志（电子版）》2015年第4期20-23,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的评估微创经皮肾镜取石术(MPCNL)术后无管化治疗3岁以下婴幼儿肾结石的安全性和可行性。方法将自2009年9月至2012年9月收治的70例3岁以下婴幼儿肾结石患儿随机分为无管化组(35例)和标准组(35例)两组,比较两组间手术时间、血红蛋白下降值、输血率、术后并发症、住院时间等指标上的差异。结果两组平均年龄、结石直径、术前血红蛋白、术后血红蛋白下降、手术时间等指标无统计学差异:无管化组平均年龄19.5个月,标准组平均年龄为17.7个月;无管化组平均结石直径2.2 cm,标准组2.4 cm;无管化组术前平均血红蛋白值11.2 g/dl,标准组10.8 g/dl;标准组平均手术时间为55 min,无管化组为53 min;无管化组结石清除率97.8%,标准组94.3%;无管化组术后血红蛋白下降(0.9±0.1)g/dl,标准组(0.8±0.2)g/dl;无管化组术后发热5.7%,标准组8.6%。但无管化组的住院时间明显少于标准组(4.7 d vs 7.8 d,P<0.001)。结论 MPCNL术后无管化治疗3岁以下婴幼儿肾结石具有恢复快,住院时间短等优点,是安全可行的。Objective To assess the feasibility and safety of the tubeless therapy for infants under three who had undergone minimally invasive percutaneous nephrolithotomy （MPCNL） for enal calculi. 70 infants under three years old with kidney stones from September 2009 to September 2012 were randomly divide into two groups, tubeless grsoup （35 cases） and standard group （35 cases）. Operative time, hemoglobin, blood transfusion, complications, duration of hospital and other indicators were compared between the two groups. Results There were no significant differences in mean age, stone size, average hemoglobin, operative time and other indicators, as follows： mean age, 19.5 month in tubeless group versus 17.7 month in standard group. Average stone size, 2.2 cm in tubeless group versus 2.4 cm in standard group. Average preoperative hemoglobin, 11.2 g/dl in tubeless group versus 10.8 g/dl in standard group. Average operative time, 55 min in standard group versus 53 min in group tubeless. Stone clearance rate, 97.8% in tubeless group versus 94.3% in standard group. Decreased hemoglobin, （0.9±0.1） g/dl in tubeless group versus （0.8±0.2） g/dl in standard group. Postoperative fever, 5.7% in tubeless group versus 8.6% in standard group. However, Average hospital stay （4.7 days） of the tubeless group were shorter than the standard group （8 days）. Conclusions The tubeless therapy is safe and feasible for infants under three years old with renal calculi.

关 键 词：肾造口术 经皮 肾结石 无管化 婴幼儿 

分 类 号：R726.9[医药卫生—儿科]