儿童泌尿系结石腔内微创治疗的疗效评价  

Evaluation of minimally invasive treatment of urinary calculi in children

作　　者：阿不力孜·司马义[1] 雷鹏[1] 艾合买提·艾买尔[1] 塔来提·塔依尔 张小安[1] Abulizi·Simayi;Lei Peng;Aihemaiti·Aimaier;Talaiti·Tayier;Zhang Xiaoan(Department of Urology,the 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：《国际泌尿系统杂志》2022年第2期258-263,共6页International Journal of Urology and Nephrology

摘　　要：目的探讨儿童泌尿系结石腔内微创治疗的安全性和临床疗效。方法回顾性分析本院自2010年1月至2018年12月采用腔内微创治疗的381例泌尿系结石患儿的临床资料,其中男性244例,女性137例。年龄段分布分别为:0~3岁190例(49.9%),3~6岁97例(25.5%),6~14周岁94例(24.7%)。按手术方式将患儿分为经皮肾镜组(231例)、输尿管镜组(60例)、输尿管软镜组(19例)及膀胱尿道结石组(71例)。比较分析四组患儿的手术时间、术后Clavien-Dindo并发症分级情况、术后1个月结石清除率及术后住院时间等临床资料。结果四组患儿手术时间分别为(70.57±33.96)、(70.60±29.80)、(59.47±32.01)及(53.27±19.65)min,其中膀胱尿道结石组与输尿管镜组、经皮肾镜组比较,差异有统计学意义(P=0.048、0.009),其他各组间比较,差异均无统计学意义(均P>0.05)。四组术后的一级并发症发生率分别为21.6%(50/231)、21.7%(13/60)、10.5%(2/19)及16.9%(12/71),组间差异均无统计学意义(均P>0.05);二级并发症发生率经皮肾镜组为9.5%(122/231),膀胱尿道结石组为1.4%(1/71),其他两组未发生;三级并发症发生率经皮肾镜组为1.3%(3/231),其他三组均未发生。四组的术后1个月结石清除率分别为89.2%(206/231)、98.3%(59/60)、100%(19/19)及100%(71/71),差异均有统计学意义(均P<0.001)。四组的住院时间为(5.97±3.41)、(5.79±3.31)、(2.42±1.38)及(4.88±3.18)d,其中经皮肾镜组、输尿管镜组、膀胱尿道结石组与输尿管软镜组比较,差异均有统计学意义(均P<0.001),其余各组间比较,差异均无统计学意义(均P>0.05)。结论儿童泌尿系结石腔内微创治疗具有创伤小、安全、有效、住院时间短、术后结石清除率高等特点。Objective To explore the safety and clinical efficacy of minimally invasive treatment for urinary calculi with children.Methods A retrospective analysis was performed on the clinical data of 381 children with urolithiasis who received endovascular minimally invasive treatment in our hospital from January 2010 to December 2018,including 244 males and 137 females.There were 190 cases(49.9%)aged 0-3 years,97 cases(25.5%)aged 3-6 years,and 94 cases(24.7%)aged 6-14 years.The children were divided into percutaneous nephroscopy group(231 cases),ureteroscopy group(60 cases),soft ureteroscopy group(19 cases)and cystourethral calculi group(71 cases)according to surgical methods.The operative time,postoperative Clavien-Dindo complication grade,postoperative calculus clearance rate 1 month,postoperative hospital stay and other clinical data of the four groups were compared and analyzed.Results The operative time of the four groups was(70.57±33.96),(70.60±29.80),(59.47±32.01)and(53.27±19.65)min,respectively.The difference between the cystourethral calculi group,ureteroscopy group and percutaneous nephroscopy group was statistically significant(P=0.048,0.009).There was no significant difference among other groups(P>0.05).The incidence of primary complications in the four groups was 21.6%,21.7%,10.5%and 16.9%,respectively,with no statistical significance(all P>0.05).The incidence of secondary complications was 9.5%in percutaneous nephroscopy group and 1.4%in bladder and urethral calculi group,but no complications occurred in the other two groups.The incidence of tertiary complications was 1.3%in the percutaneous nephroscopy group,but none in the other three groups.The stone clearance rates of the four groups were 89.2%,98.3%,100%and 100%,respectively,with statistical significance(P<0.001).The length of hospital stay of the four groups was(5.97±3.41),(5.79±3.31),(2.42±1.38)and(4.88±3.18)d,and there were statistically significant differences between the percutaneous nephroscopy group,ureteroscopy group,cystourethral calcu

关 键 词：泌尿系疾病 结石 儿童 外科手术 微创性 

分 类 号：R726.9[医药卫生—儿科]