侧卧位B超引导下微创经皮肾镜取石术治疗儿童肾结石37例疗效观察

Treatment of pediatric renal calculi by ultrasonography-guided minimally invasive percutaneous nephrolithotomy in lateral decubitus position: a report of 37 cases

目的探讨B超引导下侧卧位微创经皮肾镜取石术治疗儿童肾结石的安全性和临床应用价值。方法 2007年5月至2012年1月期间,我院采用侧卧位B超引导下微创经皮肾镜取石术治疗儿童肾结石37例,男17例,女20例,年龄3-13岁,平均9岁。结果 37例患者都在B超引导下成功建立手术通道取石,其中一期手术29例,二期手术8例;一次手术结石清除32例,5例结石残留者术后辅以ESWL治疗手术,手术时间25-100min,平均67min。术后发热3例（39℃以下,少于3d）,术中、术后无低体温,无肾贯通伤、肾实质严重撕裂等严重并发症,无输血。结论 B超引导下侧卧位微创经皮肾镜取石术治疗儿童肾结石安全、有效,创伤小,值得推广。

Objective To evaluate the clinical efficacy and safety of treating pediatric renal calculi by ultrasonography-guided minimally invasive percutaneous nephrolithotomy （MPCNL） in lateral decubitus position. Methods The clinical data of 37 patients of pediatric renal calculi treated by MPCNL in lateral decubitus position from May 2007 to January 2012 was collected, including 17 males and 20 females, 3~13 years old, 9 years in average. Results The percutaneous renal access was established in all the patients, with 29 patients by one-stage operation, 8 patients by two-stage operation. Thirty-two patients had the stones cleared by one operation （86.5% , 32/37）, five （13.5%） were further treated with ESWL therapy. The operation duration was 25~100 min, 67 min in average. Minor pyrexia （〈39℃,〈 3 days） was seen in 3 patients, none of the patients had hypothermia. There were no severe complications. No one required blood transfusion. Conclusion Ultrasonography-guided MPCNL in lateral decubitus position is safe and effective for treating pediatric renal calculi, with less trauma, which is worthy to be widely used.