输尿管镜钬激光碎石术治疗儿童输尿管中下段结石  

Ureteroscopic holmium laser lithotripsy for the treatment of middle and distal ureteric calculi in children

作　　者：顾楠楠[1] 马耿[1] 葛征[1] 陆如纲[1] 郭云飞[1] 

机构地区：[1]南京医科大学附属南京儿童医院泌尿外科,南京210008

出　　处：《中华腔镜泌尿外科杂志（电子版）》2015年第6期5-7,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨输尿管镜钬激光碎石术治疗儿童输尿管中下段结石的临床效果。方法对南京医科大学附属南京儿童医院泌尿外科2012年1月至2014年12月的32例输尿管中下段结石患儿行输尿管镜钬激光碎石术治疗的临床资料进行回顾性分析。结果 32例患儿中成功行输尿管镜钬激光碎石术25例,一次性结石清除24例,成功率为96%。7例输尿管镜进入受阻,扩张无效而终止操作,其中4例改行输尿管切开取石术,3例患儿终止手术。术中出现结石上移2例,反复冲洗后,1例结石下移,1例未见下移。术后14例患儿出现轻微肉眼血尿,1~2 d后消失。2例术后发热,经抗感染治疗后体温正常。术后患儿均未发现输尿管穿孔、撕脱等并发症。随访1~12个月,手术成功者未见结石复发,未见输尿管狭窄、膀胱输尿管返流等并发症。结论输尿管镜钬激光碎石术在治疗儿童中下段输尿管结石方面是一种比较理想的治疗方法。Objective To evaluate the efficacy of ureteroscopic holmium laser lithotripsy for the treatment of children with middle and distal ureteric calculi.Methods From January 2012 to December 2014,32 children with middle or distal ureteric calculi were treated by ureteroscopic holmium laser lithotripsy.The clinical outcome was evaluated.Results Twenty five of the 32 cases were successfully underwent the ureteroscopic holmium laser lithotripsy.Among which,24（96%） cases were cleaned the calculi in one stage operation.In 7 cases,the ureteroscope was unable to go through the obstruction of the ureter.Four of them underwent ureter lithotomy.And three cases aborted operation.Two cases had a translocation of calculi to the upper ureter.One discharged the calculi with saline flow while the other failed.After operations,slight gross hematuria was observed in 14 children.And lasted for 1-2 days,two children had postoperative fever which recovered by anti-infective therapy.None was found with ureteral perforation,avulsion or other complications after surgery.In 12 month follow-up,no stone recurrence,ureteral stenosis,vesicoureteral reflux or other complications were discovered in the patients who were carried out by ureteroscopic holmium laser lithotripsy successfully.Conclusions Ureteroscopic holmium laser lithotripsy is an ideal treatment for middle and distal ureteric calculi in children.

关 键 词：输尿管结石 输尿管镜 钬激光 儿童 

分 类 号：R726.9[医药卫生—儿科]