应用Turner-Warwick切口治疗小儿膀胱结石及输尿管结石的体会

The experience to treat bladder calculi and ureteral calculi with Turner-Warwick incision in children

目的:探讨Turner-Warwick切口治疗小儿输尿管下段结石合并膀胱结石开放手术的方法。方法:本院在2006～2010年收治的4例输尿管下段结石合并膀胱结石患儿,年龄4～8岁,平均5.8岁,其中3例男孩,1例女孩,输尿管下段结石合并膀胱结石2例,双侧输尿管下段结石1例,一侧输尿管下段结石1例,均采用Turner-Warwick切口,行输尿管切开取石术联合膀胱切开取石术,均行膀胱造瘘术,不放置双"J"管,均于输尿管内放置硬膜外导管经膀胱造瘘管引出体外。结果:4例均成功取出结石,7～9d拔除膀胱造瘘管和硬膜外导管,无尿外渗及切口感染,随访无复发。结论:对8岁以下小儿不适合行输尿管镜碎石及ESWL的输尿管下段结石合并膀胱结石的患者,本术式是不错的选择。

Objective： To evaluate the open surgery method of treating pediatric lower ureteral calculi and bladder calculi with Turner-Warwick incision. Methods： Between 2006 to 2010 years, 4 cases of lower ureteral calculi and bladder calculi pediatric patients consists of 1 girl and 3 boys whose age ranged from 4 to 8 years, mean age 5.8 years underwent open surgery, included 2 cases of lower ureterolithotomy combining cystolithotomy, 1 case of two side of lower ureterolithotomy, 1 case of lower ureterolithotomy. The stones were located on two side lower ureter in 1 case, the one side ureter in 1 case. All of the surgery collected Turner-Warwick incision, and underwent cystostomy, and didn′t detained D-J tube, and detained epidural catheter in ureter through bladder to outside the body. Results： Stones were successfully removed in 4 cases, 7-9 days removal of bladder fistula and epidural catheter, no urinary leakage and wound infection, follow-up without recurrence. Conclusion： Children under the age of 8, is not suitable for ureteroscopic lithotripsy and ESWL for lower ureteral stones combining bladder stones, the open surgery of Turner-Warwick incision is a good choice.