摘要
目的探讨体外冲击波碎石(ESWL)治疗三聚氰胺致婴幼儿肾鹿角形结石的效果和副作用。方法采用DornierCompactDeltaⅡ型碎石机ESWL治疗婴幼儿鹿角形结石22例。年龄10～36个月,平均(22.9±6.3)个月。身长68～100cm,平均(80±7.3)cm。体重7～16.5kg,平均(12.0±2.6)kg。采用超声或X线定位。冲击次数300～1500次,工作电压8～12kV。结果 22例肾结石1次治愈11例(50%),2次9例(40.45%),1例(4.54%)多发性右肾结石效果不明显改成经皮肾镜取石术(PCNL)治疗,残石1例(4.54%)。3个月结石排净率为90.91%。所有患儿麻醉苏醒后耐受良好,无石评定时间平均24.68d。无严重并发症。20例(90.90%)术后有1～3次肉眼血尿。3例出现石街,长度1.9～4.3mm,经再次ESWL碎石成功。结论 ESWL治疗三聚氰胺致婴幼儿鹿角形结石的方法是安全的、有效的。建议身长<100cm患儿ESWL治疗时,辅助合理的托扶姿势以配合超声跟踪定位较精确,36个月以下的婴幼儿采用成人治疗剂量的1/8～1/6。
Objective To evaluate the effectiveness and safety of extracorporeal shock wave lithotripsy in the treatment of staghorn calculi in children.Methods Between March 2009 and July 2010,22 patients were treated for renal staghorn calculi.All treatments were performed with Dornier Compact DeltaⅡ lithotripter.The mean age was (22.9±6.3) months (ranged from 10 months to 36 months).Length was from 68 mm to 100 mm,average (80±7.3) cm.Weight was from 7 to 16.5 kg,average (12.0±2.6) kg.The number of shock wave was 300 to 1500 shock waves/session.The voltage was started at 8 kV and increased stepwise to 12 kV.Stone clearance was assessed at 3 months.Results Eleven of 22 renal staghorn calculi were effective after first SWL (50%) treatment,9 were effective after the 2nd SWL sessions (40.45%).One failed and received PCNL (4.54%).The residual fragments of renal calculi were occurred in 1 case (4.54%).The overall stone free rates for renal staghorn calculi were 90.91%.No serious complications during and after the treatment were observed in this group.Conclusions ESWL was an effective procedure for the treatment of staghorn calculi in childhood.For children with height less than 100 mm,correct way of holding infant needed to help with ultrasound positioning is recommended while treated with SWL.Doses should be carefully managed:children under 3 were treated with 1/8 to 1/6 of the adult energy level.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第6期1583-1587,共5页
Chinese Journal of Clinicians(Electronic Edition)
关键词
碎石术
肾结石
婴儿
Lithotripsy
Kidney calculi
Infant
