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目的探讨经皮肾穿刺微造瘘取石术(mini-PCNL)治疗儿童肾结石的手术技巧及临床应用价值。方法回顾性分析总结35例儿童肾结石患儿采用mini-PCNL术治疗的临床资料。结果22例Ⅰ期取净结石,12例经二次取石,9例取净,另有1例经三次取石仍未取净。4例有残石者术后配合ESWL治疗,2例排净。随访2~32个月,患儿肾积水明显好转,结石无复发,7例肾盏颈部扩张者狭窄消失。1例有少许残石患儿结石体积有增大。结论mini-PCNL治疗儿童肾结石创伤小,安全、有效。结合术后ESWL治疗可以代替开放手术而成为儿童肾复杂结石、鹿角形结石以及合并肾内狭窄的首选治疗方法。
Objective To investigate the surgical techniques and clinical value of percutaneous renal lithotomy (mini-PCNL) in the treatment of children with kidney stones. Methods The clinical data of 35 children with kidney stones treated with mini-PCNL were analyzed retrospectively. Results Twenty-two patients had stage I neoplasm, 12 cases of secondary stone, 9 cases of neoplasm, and the other 1 case of three stones. 4 cases of residual stones were treated with ESWL, 2 cases were excluded. Follow-up 2 to 32 months, children with hydronephrosis significantly improved, no recurrence of stones, 7 cases of cervical dilator stenosis disappeared. A case of children with a small amount of residual stone stones have increased volume. Conclusion mini-PCNL treatment of children with kidney stones trauma, safe and effective. Combined with postoperative ESWL treatment can replace open surgery and become the treatment of children with complex stones, antlers and renal primary stenosis combined treatment of renal stenosis.