摘要
目的评价钬激光腔内治疗小儿泌尿系统疾病的方法和疗效。方法回顾性分析采用钬激光腔内治疗18例小儿泌尿系统疾病的临床资料,男12例,女6例,年龄1～14岁(平均6.6岁)。输尿管结石6例,上段1例、中下段5例,结石直径0.5～0.9 cm;后尿道及膀胱结石7例,结石直径0.8～1.5 cm;先天性单纯性输尿管口囊肿3例,直径2.0～3.5 Cm;前、后尿道狭窄各1例,长度分别为0.4 cm和0.5 cm。进行输尿管镜和小儿膀胱镜下钬激光腔内微创治疗。结果6例输尿管镜下钬激光输尿管碎石术、7例小儿膀胱镜下钬激光膀胱结石碎石术、3例输尿管镜下钬激光输尿管囊肿去顶开窗术和2例尿道狭窄内切开加瘢痕组织切除术均一次成功,无并发症。手术时间8～25 min,平均16 min。尿道狭窄术后留置导尿管2周,拔管后次日出院;其余患儿术后留置导尿管1～3 d,住院2～5 d。术后2周拔除双J管。碎石术后随访2～12个月无残留和复发,原伴随的肾积水消失;输尿管口囊肿术后随访3～9个月无膀胱输尿管反流;尿道狭窄术后1个月和3个月时各预防性尿道扩张1次,随访4～12个月排尿通畅。结论钬激光腔内治疗小儿泌尿系统疾病安全、有效、微创,但需要积累更多的病例和更长时间的随访。
Objective To evaluate clinical effects of endoscopic Holmium： YAG laser for the treatment of urinary disease in children. Methods We reviewed clinical data of 18 children（6 girls and 12 boys,aged from 1 to 14 years,mean 6. 6 years）. Among them,6 were ureteral stone including 1 upper ureteral stone and 5 middle or lower ureteral stones,and the size of stone ranged from 0. 5 to 0. 9 cm. Seven were bladder stones with size ranged from 0. 8 to 1.5cm. Three were simple ureterocele with ureter diameter ranged from 2. 0 cm to 3. 5cm. Two were urethral stricture,one was anterior urethral stricture with 0. 4cm long, while another one was posterior stricture with 0. 5 cm long. All the children underwent ureteroscopic or pediatric cystoscopic Holmium：YAO laser. Results Operations were successfully performed without any complication. Operating time ranged from 8 to 25 minutes （mean 16 minutes）. Patients with urethral stricture were placed catheters for 14 days and hospitalized for 15 days, while the other patients were placed catheter for 1-3 days and hospitalized for 2-5 days. A Double-Jstent was inserted after uretero-lithotripsy and kept for 2 weeks postoperatively. The cases of urolithiasis were stone-free and followed-up 2 to 12 months postoperatively without recurrence. There was no reflux in patients with ureterocele postoperatively within 3-9 months follow-up. Patients with urethral stricture voided normally within 4-12 months＇ follow-up and underwent prophylactic urethral sounding in 1 and 3 months after operation. Conclusions The endoscopic Holmium：YAG laser therapy was minimally invasive, effective and safe in the treatment of urinary diseases of children.
出处
《中华小儿外科杂志》
CSCD
北大核心
2007年第9期455-457,共3页
Chinese Journal of Pediatric Surgery
关键词
泌尿系疾病
内窥镜外科手术
激光
Urologic disease
Endoscopic surgical procedures
Laser
