儿童肾结石的微创经皮肾镜术处理

Minimally invasive percutaneous nephrolithotomy in children

目的总结微创经皮肾镜术治疗儿童肾结石的经验，评价其安全性和疗效。方法对5例儿童肾结石行微创经皮肾镜取石术（PCNL）治疗，患儿先留置患侧输尿管导管后取俯卧位，B超引导下建立工作通道，用钬激光碎石机碎石。结果5例患儿均一期通过单通道成功完成PCNL，无中转开放性手术及输血病例。手术时间30～125（80）min，术中出血量30～70（50）ml，术后患儿均无结石残留及并发症。结论在成人PCNL基础上，针对儿童PCNL的特点，改进手术技巧，可提高儿童PCNL的安全性和有效性。年龄不是该技术开展的阻碍因素。

Objective To summarize the experience and evaluate the safety and efficacy on minimal- ly invasive percutaneous nephrolithotomy （MPCNL） in management child renal calculi. Methods Five chil- dren with renal calculi who were underwent MPCNL were retrospectively analyzed. After retrograde catheteriza- tion in lithotomy position, the nephrostomy tract were established with ultrasound. Then stones were fragmented with Holmium laser lithotriptor. Results Five cases undergoing MPCNL with single tract in stage one were all successful without conversion to open surgery and blood transfusions. The operative time was30 - 125 （80） min. Blood loss was 30 - 70 （50） ml. There were no residual stones or complications. Conclusions On the basis of MPCNL in adult, it is an effective and safe treatment for renal calculi in children if special attention was paid. Age is not a hindering factor of MPCNL in children.