肋上入路微创PCNL治疗儿童结石的疗效观察

Efficacy of minimally invasive PCNL with supracostal approach in the treatment of pediatric renal stones

目的:探讨肋上入路微创经皮肾镜取石术(PCNL)治疗儿童肾结石的安全性和有效性。方法:回顾性分析采用PCNL治疗儿童肾结石患者54例的临床资料:54例患者根据手术入路分为A、B两组,A组29例接受12肋上穿刺入路,B组25例接受12肋下穿刺入路,对比A、B两组PCNL的手术结果及并发症情况。结果:A、B两组手术时间分别为124min和128min(P>0.05),术后结石清除率分别为91.2%和90.7%(P>0.05),术后发热例数分别为1例和2例,血气胸分别为2例和1例,两组均无严重出血或尿外渗等并发症。结论:采用肋上入路PCNL治疗儿童肾结石安全、有效。

Objective：To evaluate the safety and efficacy of minimally invasive PCNL with supracostat approach in pediatric patients. Method：The clinical data of 54 pediatric patients treated by PCNL were retrospectively analyzed. Patients were divided into two groups （group A and group B） according to the surgical approach. There were 29 patients with the supracostal approach of the 12th rib and 25 patients with the subcostal approach. The outcomes and complications of these 54 patients were analyzed retrospectively. Result：Surgical time of group A was 124 min and that of group B was 128 min （P〉0.05） , postoperative stone clearance rate were 91.2% and 90.7% （P〉0.05） respectively. Postoperative fever was encountered in one case and two cases respectively. Two cases and one case suffered from hemopneumothorax respectively. No severe bleeding, postoperative transfusion or urinary extravasation appeared in all cases. Conclusion：PCNL with supracostal approach in the treatment of pediatric renal stones is safe and effective.