小儿肾结石微创治疗研究进展

The Research's Progression of Minimally Invasive Treatment for Kidney Stones In Children

近年来小儿肾结石的发病率逐渐升高,体外冲击波碎石(ESWL)、经皮肾镜碎石取石术(PCNL)、输尿管软镜碎石取石术(FUL)等微创治疗技术已逐步取代开放性手术成为小儿肾结石的主要治疗手段。ESWL操作方便、创伤小及花费相对较少,但治疗体积较大和复杂性肾结石的清石率明显降低;PCNL治疗复杂性肾结石有较大的优势,但其并发症(如大出血、肾及周围脏器损伤等)的发生却不容小觑;FUL有更加微创、并发症少、可反复治疗等优点,但由于设备昂贵、易损耗、治疗成本高等原因限制了其在临床的推广应用。本文主要对微创治疗在小儿肾结石中的应用做一综述。

In recent years,the incidence of kidney stones in children gradually increased. The minimally invasive treatment technology which includes extracorporeal shock wave lithotripsy( ESWL),percutaneous nephrolithotomy( PCNL) and flexible ureteroscopic lithotripsy( FUL) has gradually replaced the traditional open surgery as the main treatment of pediatric kidney stones.ESWL has the advantages of convenient operation,less trauma,less cost and so on,but its rate of clearing stone decreased significantly in the treatment of the larger and complex renal calculi. PCNL has a greater advantage in the treatment of complex kidney stones,but its complications such as hemorrhage,the damage of kidney and peripheral organ can't be ignored. FUL has advantages of more minimally invasive,less complications,repeated treatment and so on,but the more expensive medical instruments,medical loss and higher treatment costs make its clinical application obviously limited. This article mainly reviews the application of minimally invasive treatment in children's kidney stones.