微造瘘经皮肾镜碎石术治疗学龄前儿童上尿路结石

Minimally invasive percutaneous nephrolithotomy in preschool age children

目的评价微造瘘经皮肾镜碎石术在治疗学龄前儿童上尿路结石的安全性和有效性。方法应用B超引导穿刺的微造瘘（16F）经皮。肾镜碎石术治疗平均年龄46个月的学龄前患儿35例共42侧上尿路结石。其中肾结石34侧，上段输尿管结石8侧，结石平均长径（16．9±9．2）mm。结果所有病例均Ⅰ期成功建立通道并处理结石。手术时间平均为（35．4±14．9）min，手术清除率分别为92．9％，术后血红蛋白含量下降了12．7％，术后感染率5．0%，没有需要输血，毗邻脏器损伤或循环超负荷的病例。结论微创经皮肾镜碎石术治疗学龄前儿童上尿路结石是安全、有效的。

Objective To evaluate the efficacy and safety of minimally invasive percutaneous nephrolithotomy （Mini-PNL） in preschool age children. Methods Between December, 2005 and De cember 2007, 42 Mini-PNL were performed in 35 preschool age children whose mean age was 46 months. Thirty-four calculi were in kidney, 8 in upper ureter. The mean stone dimension was 16.9 ± 9. 2 mm in length. Results One session Mini-PNLs were successfully performed in all children. The mean operation time was 35.4 ± 14. 9 min. The stone free rate was 92. 9%. The postoperative hemoglobin level dropped by 12.7% but no blood transfusion was required. 5% children suffered postoper ative infection. Conclusions Mini-PNL is an effective and safe procedure in treatment of upper urinary stones in preschool age children.