体外冲击波碎石术治疗儿童泌尿系结石(附47例报告).docVIP

体外冲击波碎石术治疗儿童泌尿系结石(附47例报告)【摘要】 目的 探讨体外冲击波碎石术(ESWL)治疗儿童泌尿系结石的临床疗效。方法 回顾性分析2006~2010年47例经体外冲击波碎石术治疗的儿童泌尿结石的临床资料,其中肾盂肾盏结石19例,输尿管结石22例,膀胱结石4例,后尿道结石2例。结果 结石平均清除率为95?6%,成功率为97?8%,结石残留2例(4?2%),1例无效(2?1%),改行手术治疗,无严重并发症。结论 ESWL治疗儿童泌尿系结石安全、有效,是治疗儿童泌尿系结石的首选方法。? 【关键词】 儿童;泌尿系结石;体外冲击波碎石术(ESWL) Clinical effects of extracorporeal shock wave lithotripsy for treatment of urinary tract calculi in children (Report of 47 cases) YU Zhao?cun,XING Fa?shu,ZHENG Zhe?ming,et al? Department of Urology,Houjie Hospital of Dongguan,Dongguan 523945,China 【Abstract】 Objective To evaluate the efficicy and safety of extracorporeal shock wave lithotripsy(ESWL)in the treatment of urinary calculi in children?Methods 47cases of paediatric urinary calculi treated with ESWL from 2006 to 2010 were analysed retrospectively and discussed with review of the literature?Of the 47 children,19 had nephrolith,22 had ureter calcli,4 had bladder and 2 had posteriorurethra calculi?Results The overall stone free rate after ESWL was 95?6%,and the successful rate was 97?8%?Two cases(4?2%)have residual fragments?Only one case(2?1%)was failure then treated with open surgery?Stone was quickly and smoothly relased with little complications? Conclusion ESWL is a safe and effective treatment for paediatric urolithiasis,so it should be considered the first choice to treat paediatric urinary calculi?? 【Key words】 Clildren Urinary tract calculi;Extracorporeal shock wave lithotripsy ? 体外冲击波碎石术(ESWL)已成为泌尿系结石安全、有效的首选治疗方法,2006年8月至2010年10月,我们采用德国多尼尔王者碎石机(Dornier lithotripler S)治疗儿童泌尿系结石47 例,效果满意,现报告如下。? 1 资料与方法? 1?1 一般资料 本组47例,男36例,女11例,年龄3～14岁,平均8?9岁。其中6例有排石病史,2例有开放手术取石病史,9例并发泌尿系解剖异常,3例曾行先天性肾输尿管交界处狭窄(UPJ)成形术。结石位置:左肾结石7例,右肾结石11例,双肾结石1例,其中鹿角形结石2例,多发性结石3例,独肾并结石1例;单侧输尿管结石19例,双侧输尿管结石3例,其中上段结石11例,中段结石6例,下段结石5例;膀胱结石4例,后尿道结石2例。上尿路结石多以腰痛和血尿就诊,下尿路结石以尿频、排尿困难为主。肾结石最大2?1 cm ×1?8 cm,最小0?8 cm×0?6 cm;输尿管结石最大0?8 cm×0?7 cm,最小0?4 cm×0?3 cm;膀胱结石最大3?6 cm×3?2 cm,最小1?5 cm×1?2 cm。术前经腹部平片(KUB)、静脉肾盂造影(IVP)、B超和CT等检查确诊为尿路结石