摘要
目的评价超声引导下单通道微创经皮肾镜取石术在西藏地区儿童肾结石应用中的安全性和有效性。方法回顾性分析2014年8月至2018年7月在西藏自治区人民医院行单通道微创经皮肾镜取石术治疗肾结石110例患儿的临床资料,其中男82例,女28例,比率2.9∶1;年龄3~12岁,平均(9.5±5.2)岁;结石大小2.0~2.7cm,平均(2.4±1.2)cm。左侧51例,右侧59例。对患儿的血常规、手术时间、术中或术后是否输血、并发症、清石率等术后资料进行统计。结果110例患儿的手术均获得成功,手术时间为25~60min,平均(33.5±8.5)min。术中均无明显出血,术中均未输血。术后复查血常规,血红蛋白118~150g/L,平均(132.5±16.3)g/L,与术前比较,血红蛋白均未见明显变化(P>0.05)。所有患儿术后复查电解质,无低钠低钾血症的发生。术后1周复查,仅2例患儿存在结石残留,其余108例均无结石残余。一期结石清除率为98.2%。术后9例患儿出现发热(体温>38.5℃),发生率8.2%,予以广谱抗生素治疗后,体温恢复正常。所有患儿均无周围脏器损伤(如肠道、气胸等)、无大出血等严重并发症。结论单通道微创经皮肾镜在西藏地区治疗儿童肾结石效果确切,清石率高。
Objective To evaluate the clinical efficacy and safety of single channel minimally invasive percutaneous nephrolithotomy(SCMPNCL)in treating children with renal calculi in Tibet.Methods The clinical data of 110 children treated with SCMPNCL during Aug.2014 and July 2018 were retrospectively analyzed.The patients included 82 boys and 28 girls,aged 3.0-12 years,average(9.5±5.2)years.The stone diameter was 2.0-2.7 cm,average(2.4±1.2)cm.The calculi were in the left in 51 cases,and in the right in 59 cases.Results All operations were successful.The operation time was 25-60 min,average(33.5±8.5)min.No blood transfusion was needed.No bleeding was observed.Postoperative blood routine examination showed the hemoglobin was 118-150 g/L,average(132.5±16.3)g/L.The t test showed no difference between the pre-and post-operative hemoglobin level(P>0.05).No hyponatremia or hypokalemia was detected.After 1-week follow-up,residual calculi were observed in 2 children.The one-stage stone free rate was 98.2%.Fever occurred in 9 cases(8.2%).After broad spectrum antibiotic therapy,all children returned normal.No severe complications such as severe injury or hemorrhage occurred.Conclusion The SCPCNL is safe and effective in the treatment of renal calculi in children.
作者
张宝鹏
斯郎江村
牛吉瑞
ZHANG Bao-peng;SI LANG Jiang-cun;NIU Ji-rui(Department of Urology,People’s Hospital of Tibet,Lasa 850000;Department of Urology,Heilongjiang Provincial Hospital,Harbin 150036,China)
出处
《现代泌尿外科杂志》
CAS
2019年第9期722-724,共3页
Journal of Modern Urology
关键词
单通道经皮肾镜取石术
肾结石
西藏
清石率
儿童
single channel percutaneous nephrolithotomy
renal calculi
Tibet
stone free rate
children
