可视化穿刺经皮肾镜在儿童肾结石中的临床应用

Clinical application of visual puncture micro-percutaneous nephrolithotomy for treatment of renal stones in pediatric patients

目的探讨可视化穿刺经皮肾镜在治疗儿童肾结石的安全性和有效性。方法 2017年6月~2018年8月儿童肾结石15例,均在全麻下行可视化穿刺经皮肾镜钬激光碎石术,评估手术时间、术后并发症及住院时间,术后4周复查泌尿系统CT评估结石清除率。结果所有患儿均成功完成可视化穿刺经皮肾镜钬激光碎石术,手术平均时间(68.43±11.45)分钟;术后血红蛋白下降(8.50±1.70)g/L,术后无输血患儿;术后住院时间(5.36±0.84)天;术后2例患儿出现发热,体温>38.5℃,为Clavien gradeⅡ并发症,分别按照药敏结果给予加强抗感染治疗后好转;术后4周结石清除率为86.67%(13/15)。结论可视化穿刺经皮肾镜治疗儿童肾结石安全、有效,并发症低,可以达到满意的结石清除率。

Objective To explore the safety and efficacy of visual puncture micro-percutaneous nephrolithotomy for treatment of renal stones in pediatric patients.Methods The clinical data of 15 pediatric patients with renal stones treated with visual puncture micro-percutaneous nephrolithotomy in our department from June 2017 to August 2018 were enrolled.All patients were performed holmium laser lithotripsy of visual puncture micro-percutaneous nephrolithotomy under general anesthesia and the operation time,postoperative complications and hospitalization time were evaluated.The urinary CT was reviewed 4 weeks after the operation to evaluate the stone-free rate.Results All patients were performed holmium laser lithotripsy of visual puncture micro-percutaneous nephrolithotomy successfully.The average operation time was(68.43±11.45)min.The average decrease of hemoglobin was(8.50±1.70)g/L,and none of cases required blood transfusion.The average day of postoperative hospitalization was(5.36±0.84)d.Postoperative fever occurred in 2 patients(T>38.5℃),which was a complication of Clavien grade II,and they were improved after intensive anti-infection treatment according to the drug sensitivity results.The stone-free rate at 4 weeks was 86.67%(13/15).Conclusion Visual puncture micro-percutaneous nephrolithotomy for the treatment of renal stones in pediatric patients is safe and effective,with low complications,and achieve a satisfactory stone-free rate,which can be popularized in clinical practice.