静脉肾盂造影辅助体外冲击波碎石术治疗小儿输尿管中下段阴性结石  

Intravenous Pyelography Assisted Extracorporeal Shock Wave Lithotripsy in the Treatment of Negative Middle and Lower Ureteral Calculi in Children

作　　者：高栩 胡岩[1] Gao Xu;Hu Yan(Department of Urology,Children’s Hospital of Hebei Province,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院泌尿外科,石家庄050031

出　　处：《中国微创外科杂志》2022年第7期595-598,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：河北省医学科学研究重点课题计划(20200643)。

摘　　要：目的探讨静脉肾盂造影(intravenous pyelography,IVP)辅助体外冲击波碎石术(extracorporeal shock wave lithotripsy,ESWL)治疗小儿输尿管中下段阴性结石的疗效。方法我院2012年6月~2018年6月采用IVP定位辅助ESWL治疗小儿输尿管中下段阴性结石16例,术中借助IVP显示阴性结石充盈缺损,X线定位下进行高频低能级ESWL,震波600~1200次,平均900次。结果术中观察到造影剂连续性恢复4例。手术时间30~45 min,平均38 min。住院时间4~7 d,平均5 d。术日排石11例,术后第2天排石5例。术后1周复查泌尿系B超或CT示结石消失,结石排净率100%。术后无石街、输尿管穿孔、尿源性脓毒血症等并发症。16例随访3个月,结石无复发,未发生并发症。结论IVP辅助ESWL治疗小儿输尿管中下段阴性结石可行,安全有效。Objective To investigate the effect of intravenous pyelography(IVP)assisted extracorporeal shock wave lithotripsy(ESWL)in the treatment of negative middle and lower ureteral calculi in children.Methods Clinical data of 16 children with negative ureteral calculi treated with IVP positioning assisted ESWL in our hospital from June 2012 to June 2018 were retrospectively analyzed.During the operation,negative calculi filling defects were shown by intravenous pyelography,and then high-frequency low-level ESWL was performed under X-ray positioning.The shock waves were 600-1200 times,with an average of 900 times.Results Intraoperative continuous recovery of contrast medium was observed in 4 cases.The operation time was 30-45 min(mean,38 min),and the hospital stay was 4-7 d(mean,5 d).The stone removal was observed in 11 cases on the day of operation and in 5 cases on the second day after operation.One week after the operation,B-ultrasound or CT showed that the stones disappeared and the stone clearance rate was 100%.There were no stone street,ureteral perforation,urinary sepsis or other complications.After surgery,all the 16 children were followed up for 3 months.There was no stone recurrence or complications.Conclusion IVP assisted ESWL is feasible,safe,and effective in the treatment of negative middle and lower ureteral calculi in children.

关 键 词：静脉肾盂造影 体外冲击波碎石 小儿 输尿管 阴性结石 

分 类 号：R726.9[医药卫生—儿科]