经皮肾镜治疗婴幼儿上尿路结石的有效性及安全性研究  

Comparative study on the treatment of upper urinary calculus in infants and toddlers by percutaneous nephrolithotomy

作　　者：阿不力孜·司马义[1] 塔来提·塔依尔 雷鹏[1] 张小安[1] 艾合买提·艾买尔[1] 亚力坤·阿力木[1] 文彬[1] Abulizi·Simayi;Talaiti·Tayier;Lei Peng;Zhang Xiaoan;Aihemaiti·Aimaier;Yalikun·Alimu;Wen Bin(Urology Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院泌尿中心,乌鲁木齐830001

出　　处：《中华小儿外科杂志》2021年第9期794-798,共5页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨经皮肾镜治疗婴幼儿上尿路结石的有效性和安全性。方法回顾性分析新疆维吾尔自治区人民医院泌尿中心自2010年1月至2019年12月114例行经皮肾镜碎石术治疗上尿路结石患儿的临床资料。依据通道型号不同分为组1(F12~14,61例)及组2(F16,53例),组间性别、并发症差异采用卡方检验,年龄、身长、体重、结石表面积、术后48 h净石率、手术无管化率、手术时间、术后住院时间、血红蛋白降低情况对比使用Mann-Whitney U检验。结果组1患儿术后48 h净石率为91.8%,组2患儿术后48 h净石率为98.1%,P=0.278,差异无统计学意义。34例完全无管化的患儿均来自组1。组1中位手术时间为41.5 min,组2中位手术时间为90 min,P=0.413,差异无统计学意义。组1术后住院时间为4 d,组2为6 d,P=0.373,差异无统计学意义。组1术后第一天血红蛋白下降值中位数为5 g/L,组2为4.5 g/L,P=0.335,差异无统计学意义。组1共发生19例(31.1%)并发症,组2发生22例(41.6%),P=0.25,差异无统计学意义。结论经皮肾镜手术治疗婴幼儿上尿路结石安全有效,较小的穿刺通道更利于快速康复。Objective To explore the efficacy and safety of percutaneous nephrolitotomy for upper urinary calculus in infants and toddlers.Methods From January 2010 to December 2019,retrospective analysis of clinical data was performed for 114 children with upper urinary calculus undergoing percutaneous nephrolithotomy.They were divided into group 1(F12-14)and group 2(F16)according to different sizes of puncture channel.Then operative duration,tubeless ratio and 48 h post-operative stone free rate(SFR),hospitalization time,complications and hemoglobin decline were compared between two groups.Results At 48 h post-operatively,the stone free rate was 91.8%in group 1 and 98.1%in group 2(P=0.278).The difference had no statistical significance.All 34 children with complete non-tubing were from group 1.The median operative duration was 41.5 min in group 1 and 90 min in group 2(P=0.413).There was no statistical significance.Postoperative hospital stay was 4 days in group 1 and 6 days in group 2(P=0.373).The difference had no statistical significance.The median postoperative decline of hemoglobin was 5 g/L in group 1 and 4.5 g/L in group 2(P=0.335).The inter-group difference had no statistical significance.There were 19 complicated cases(31.1%)in group 1 and 22(41.6%)in group 2(P=0.25).The difference had no statistical significance.Conclusions Percutanous nephrolithotomy is both efficacious and safe for upper urinary stones in infants and toddlers.Smaller puncture channels facilitate a faster recovery.

关 键 词：穿刺术 婴儿 上尿路结石 经皮肾镜取石术 

分 类 号：R726.9[医药卫生—儿科]