体外震波碎石治疗儿童上尿路结石300例分析

Analysis of 300 cases of upper urinary tract calculi in children treated by extracorporeal shock wave lithotripsy

目的探讨体外震波碎石(ESWL)治疗儿童上尿路结石的安全性和疗效。方法采用ESWL治疗儿童上尿路结石300例,患儿年龄7个月～10岁,其中肾结石202例,输尿管结石98例。首次ESWL治疗后1周～3个月检查发现尿路梗阻或结石未排尽者再行ESWL治疗。首次ESWL治疗后3个月评定患者治疗效果。结果 202例肾结石患儿1次ESWL治愈169例(83.66%),2次ESWL治愈32例(15.84%),1例改行经皮肾镜碎石术治疗。98例输尿管结石患儿1次ESWL治愈84例(85.71%),2次ESWL治愈13例(13.27%),1例改行输尿管镜钬激光碎石术治疗。首次ESWL治疗后3个月肾、输尿管结石治愈率分别为94.55%和98.98%,所有患儿均无严重并发症发生。结论 ESWL是治疗儿童上尿路结石安全、有效的方法。

Objective To investigate the safety and therapeutic effect of extracorporeal shock wave lithotripsy(ESWL) in the treatment of upper urinary tract calculi in children. Methods ESWL was employed to treat 300 cases of upper urinary tract calculi in children who aged from 7 months old to 10 years old.Among the 300 cases,202 cases were renal calculi,and the other 98 cases were ureteral calculi.A second ESWL was performed for those with urinary obstruction or residual calculi 1 week to 3 months after first ESWL.The therapeutic effect was evaluated 3 months after first ESWL. ResultsAmong the 202 case of renal calculi,169(83.66%) were cured after first ESWL,32(15.84%) were cured after a second ESWL,and one case failed and then received percutaneous nephrolithotomy.Among the 98 cases of ureteral calculi,84(85.71%) were cured after first ESWL,13(13.27%) were cured after a second ESWL,and one case failed and received laser lithotripsy.The overall cure rates of renal calculi and ureteral calculi 3 months after first ESWL were 94.55% and 98.98%,respectively,and no serious complications were observed. Conclusion ESWL may be a safe and effective treatment for upper urinary tract calculi in children.