经皮膀胱穿刺与经尿道碎石术治疗小儿膀胱结石的临床对照研究

Comparative study of percutaneous cystoLithotripsy versus transurethral cystolithotripsy in children with bladder stones

目的探讨经皮膀胱穿刺膀胱结石碎石术(PCCL)与经尿道膀胱结石碎石术(TUCL)治疗小儿膀胱结石的临床疗效。方法回顾性分析2015年1月至2017年5在本院和阿克陶县人民医院就诊的16例PCCL与21例TUCL治疗的膀胱结石患儿的临床资料,对比两种手术方式及其疗效。结果PCCL一次性结石清除率均达100%,且无严重并发症。而TUCL组,其中1例有结石残留并需行二次碎石,一次性清石率为95%,且术后有排尿困难、尿痛等常见并发症发生。两组患儿年龄、手术时间、并发症和住院天数的比较差异无统计学意义。结论PCCL与TUCL均疗效好、结石清除率高、无严重并发症。对于手术方式的选择仍应根据术前检查结果,充分评估手术风险和难度,并结合患者具体情况以及医院的设备和手术者的技术掌握情况,制定出个体化的治疗方案。

Objective To evaluate the efficacy of percutaneous cystolithotripsy(PCCL)versus transurethral cyslithotripsy(TUCL)in children with bladder stones.Methods The clinical data of 16 children with bladder calculus treated with PCCL and 21 children with bladder calculus treated with TUCL in our hospital and people's hospital of Aketao county from January 2015 to May 2017 were analyzed retrospectively.and efficacies of these two different modalities were compared.Results The clearance rate of PCCL was 100%,and no serious complications were found.One patient had residual stone after first TUCL,needed secondary TUCL,clearance rate was 95%,and postoperative dysuria,odynuria occurred.There was no significant difference in age,operation time,complications and hospitalization days between the two groups.Conclusions Both PCCL and TUCL for bladder stones in children have good efficacy with high clearance rate and less complications.The choice of surgical methods should be based on the size of the stone,combined with the specific conditions of the patient,surgeon's skills and the hospital equipments,to develop individualized treatment program.