输尿管镜下腔内治疗婴幼儿双侧输尿管结石

Ureteroscopic intracavitary treatment of ureter calculi in infants and toddlers

目的探讨输尿管镜下腔内治疗婴幼儿双侧输尿管结石的临床疗效。方法采用输尿管镜下腔内逆行置人输尿管支架管引流或期碎石解除梗阻治疗婴幼儿双侧输尿管结石致急性梗阻18例。结果输尿管镜下Ⅰ期成功碎石4例，双侧2例，单侧2例，14例单纯逆行置入输尿管支架管引流，其中双侧逆行置管9例，单侧5例。手术时间平均38min（25-70min）；平均住院时间8d（4～18d）。二次手术3例，治愈17例，死亡1例。结论输尿管镜下腔内逆行置入输尿管支架管引流或I期碎石解除梗阻是治疗婴幼儿双侧输尿管结石有效方法之一，其微创、安全、疗效肯定。

Objective To investigate the therapeutic effect of ureteroscopic intracavitary treatment for infants or toddlers with ureter calculi. Methods Eighteen cases with acute obstruction caused by ureter calculi were treated by retrograde ureteral stent drainage or one stage lithotripsy under ureteroscope. Clinical features,mean operating period, and prognosis were analyzed. Results Of all cases,4 patients,in whom 2 suffered bilateral calculi and 2 suffered unilateral caculi, underwent one stage ureteroscopic lithotripsy. Fourteen patients underwent retrograde ureteral stent drainage under ureteroscope, including 9 cases with bilateral calculi and 5 with unilateral calculi. Seventeen patients were cured including 3 who underwent reoperations. One patient died. Conclusions Retrograde ureteral stent drainage or one stage lithotripsy under ureteroscope is a safe, effective and minimally invasive treatment for infants or toddlers with acute obstruction caused by bilateral ureteral calculi.