小儿上尿路多发结石的微创手术护理

The nursing care of minimally invasive surgy for upper urinary tract lithiasis in infants

目的探讨采用经皮肾镜、腹腔镜、输尿管镜等微创手术治疗小儿上尿路多发结石的护理要点。方法回顾分析2003年5月至2009年12月采用三种微创技术治疗12例4小儿上尿路多发结石，观察患儿的术前准备、术后护理及随访的手术效果。结果5例经皮肾镜，4例经输尿管镜钬激光碎石，3例腹腔镜输尿管切开取石，结石清除率为75％，无并发症，随访无血尿、尿路感染、腰腹痛等。结论结合小儿的生理特点，术前对患儿进行耐心细致的心理护理及充分的准备，术后做好饮食指导、管道护理及并发症的观察，小儿多发上尿路结石微创手术安全、可行、有效。

Objective To discuss the nursing care of percutaneous nephroscopic lithotripsy （PCNL）, laparoscopy and ureteroscopy for upper urinary tract lithiasis in infants. Methods From May 2003 to December 2009,12 infants of upper urinary tract lithiasis were treated by above three minimally invasive surgy. We observed preoperative preparation, postoperative care and the effect of surgery by follow-up. Results 5 infants treated by PCNL,4 infants treated by transureteroscopic holmium：YAG laser lithotripsy,3 infants treated by laparoscopic ureterolithtomy. The stone clearance rate was 75%. There was no complication, including hematuria, urinary tract infection and Lumbar pain, and so on. Conclusion Combination of physiological characteristics of infants, giving patient and careful mental nursing to infants, and well preparation before operation, and giving well diet guide, ducts nursing and conplication observing, minimally invasive surgy for upper urinary tract lithiasis in infants was safe, feasible and effective.