摘要
目的比较微创经皮肾镜取石术（MPCNL）和ESWL治疗婴幼儿肾结石的临床疗效。方法选取2005年11月至2011年7月〈3岁肾结石患儿46例。MPCNL组24例，其中双肾结石1例，年龄（22．6±8．7）个月，结石大小（21．4±3．5）mm，GFR（48．3±1．8）ml／min；ESWL组22例，年龄（23．5±6．6）个月，结石大小（21．7±1．7）mm，GFR（49．3±11．9）ml／min，两组比较差异均无统计学意义（P〈0．05）。结果MPCNL组手术时间（76．2±23．4）rain，住院时间（14．1±5．8）d，一期清石率84．0％（21／25），二期清石率96．0％（24／25），术后发热4例（16．0％），术后Hb降低（8．5±4．4）g／L，无输血病例；ESWL组一期清石率31．8％（7／22），二期碎石1l例（50．0％），3个月后复查清石率为86．3％（19／22），出现发热、严重血尿、石街等并发症10例（45．5％），住院时间（6．6±2．3）d，两组比较差异均有统计学意义（P〈0．05）。MPCNL组术后GFR为（50．6±11．9）ml／min，与术前比较差异有统计学意义（P〈0．05）。ESWL组术后GFR为（50．2±9．7）ml／min，与术前比较差异无统计学意义（P〉0．05）。结论与ESWL比较，MPCNL治疗婴幼儿〉20mm肾结石清除率高、重复治疗率低、并发症少。
Objective To compare the efficiency between mini-percutaneous nephrolithotomy （MPCNL） and extracorporeal shock wave lithotripsy （ESWL） for monotherapy of renal calculi in infants less than 3 years. Methods Forty-six infants were treated with either SWL （22 infants） or MPCNL monotherapy （24 infants）. The mean age was （22.6 ± 8.7 ） months vs （23.5 ± 6.6） months and the stone size was （ 21.4 ± 3.5 ）mm vs （21.7 ± 1.7 ） ram, and there were no significant difference. Results For MPCNL, mean operating time was （76.2 ±23.4） rain and mean hospital stay was （14.13 ±5.8） d. The stone-free rates were 84.0% （21/25） after first session and 96.0% （24/25） after second-look procedure. Postoperative fever happened in 4 （16.0%） cases. Hemoglobin drop was （8.5 ± 4.4） g/L and no one needed blood transfusion. For ESWL, the stone-free rate were 31.8% （7/22） after first session and 86.3% （19/22） after second session for 11 infants （50.0%）. Mean hospital stay was （6.6± 2.3） d and 10 cases （45.5%） had complications. Hemoglobin drop was （10.6 ± 12.7） g/L. MPCNL was lower than ESWL in complications rate and re-treatment rate, and the stone-free rate was higher, but the hospital stay and operation time was longer （P 〈 0.05）. GFR revealed improve or stable after operation in both groups. Conclusions For a higher success rate, lower complication rate and re-treatment rate, MPCNL was an effective option for the management of relatively larger stones in children （ even in infants）.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2013年第1期20-23,共4页
Chinese Journal of Urology
基金
卫生部行业科研专项项目（项目编号201002010）
广州市科技局支持资金（2009JI-C371-2）
关键词
肾结石
婴幼儿
体外碎石
经皮肾镜取石术
Infant
Renal calculi Shock wave lithotripsy
Percutaneous nephrolithotomy
