输尿管镜治疗婴幼儿输尿管结石经验交流

Experience Communication of Ureteroscopic in the Treatment of Complicated Ureteral Calculi in Infants

目的观察输尿管镜下钬激光碎石治疗复杂性婴幼儿输尿管结石的疗效和安全性。方法采用wolf-F4.5硬输尿管镜联合钬激光治疗28例婴幼儿输尿管结石,本组28例,男20例,女8例。年龄6月~1岁,平均8月。左侧输尿管结石13例,右侧11例,双侧4例;单侧输尿管结石:上段2例,中段10例,下段12例;双侧输尿管结石:上段1例,中段5例,下段2例;结石成分:草酸钙结石11例、尿酸结石5例、磷酸钙结石2例;结石横径3~6 mm,纵径6~10 mm。结果手术顺利,复查结石完全清除20例,另4例再过3月后复查也排净。随访3~12个月无结石复发,肾积水均恢复正常。结论输尿管导管扩张联合输尿管镜下钬激光碎石治疗复杂性婴幼儿输尿管结石安全有效。

Objective To evaluate the efficacy and safety of ureteroscopic holmium laser lithotripsy in the treatment of complicated ureteral calculi in infants. Methods 28 cases of ureteral calculi were treated with wolf-F4.5 rigid ureteroscope combined with holmium laser. There were 28 cases, 20 males and 8 females. The age ranged from June to 1 years, average August. Left ureteral calculi in 13 cases,right in 11 cases, 4 cases of bilateral; unilateral ureteral calculi： 2 cases upper, 10 cases of middle and lower segment in 12 cases; bilateral ureteral calculi： 1 cases in the upper and middle segment in 5 cases, 2 cases; stone composition： calcium oxalate stones in 11 cases, 5 cases of uric acid stones and calcium phosphate 2 cases of stone; stone diameter of 3 ~ 6 mm, 6 ~ 10 mm diameter. The stones were completely removed in 20 cases, and the other 4 cases were re examined after March. Follow up for 3~12 months, no stone recurrence, hydronephrosis all returned to normal. Results The operation was successful, the stones were completely removed in 20 cases, and the other 4 cases were re examined after March. Follow up for 3~12 months, no stone recurrence, hydronephrosis all returned to normal. Conclusions Ureteral catheter dilatation combined with holmium laser lithotripsy under ureteroscope is safe and effective for the treatment of complicated ureteral calculi in children, and it is worthy of clinical application;