输尿管镜气压弹道碎石术治疗小儿输尿管结石

Ureteroscope pneumatic lithotrity for children with ureteral calculi

目的探讨输尿管镜气压弹道碎石术治疗小儿输尿管结石的临床效果。方法回顾性分析应用输尿管镜气压弹道碎石术治疗小儿输尿管结石32例临床资料。结果一次性治疗成功29例,成功率90.6%,手术时间为30～120min,术后无明显血尿、感染及输尿管、尿道狭窄等并发症。结论输尿管镜气压弹道碎石术治疗小儿输尿管结石效果确切、创伤小,是治疗小儿输尿管结石的理想方法。

Objective To investigate the clinical value of ureteroscope pneumatic lithotrity （URSL） for children with ureteral calculi. Methods A total of 32 cases with ureteral stones underwent ureteroscope pneumatic lithotrity （17 male and 15 female,aged from 17 months to 14 years with a mean of 8. 5 years）. Out of 32 cases,5 patients had stones in the proximal ureter, 10 in the middle and the other 17 in the distal ureter. The stones were in the left in 19 patients,right in 11 ,and both side in 2. Twenty-three patients were associated with homolateral hydronephrosis, 6 with vesical stones, 1 with urethral and both renal stones and 4 with ureterocele（1 associated with duplication of kidney and ureter）. The stones size ranged from 0. 4 cm× 0. 5 cm× 0. 6 cm to 1.2 cm× 0. 8 cm× 0. 5 cm. Results URSL was performed on all patients. The postoperative KUB radiography showed a stone-free rate of 90. 6G （29/32） ,and a stone-residual rate of 9. 6G （3/32）. The residual stones thoroughly disappeared after the second time of URSL within half a month. The operation time ranged from 30 to 120 minutes （average 50 minutes）. Intraoperatlve ureteral perforation occurred in one patient,and a double-J stent was inserted after uretero-lithotripsy and kept for 4 weeks postoperatively. No serious complications such as obvious hematuria, infection, ureteral and urethral stricture were observed within 3-14 months followlng-up. Conclusions URSL is a safe, effective and less invasive treatment for children with ure teral calculi.