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目的探讨小儿尿路结石施行腔内微创治疗的临床价值。方法对79例小儿尿路结石患儿施行腔内微创治疗。男47例,女32例。年龄0.5～14岁,平均7.9岁。肾结石18例;输尿管上段结石14例(阴性结石和多发性结石各1例),输尿管中段结石2例,输尿管下段结石10例,膀胱内型输尿管囊肿内结石1例,肾结石合并输尿管上段结石4例;膀胱结石18例;尿道结石12例(后尿道6例,前尿道6例)。结石横径0.5～2.8 cm,长径0.5～1.5 cm。上尿路结石中左侧24例,右侧22例,双侧3例。结果30例下尿路结石、13例输尿管中下段结石行经输尿管镜碎石术(URL),1例肾盂结石、4例输尿管上段结石行后腹腔镜肾盂输尿管切开取石术(RPPL/RPUL),31例肾、输尿管上段结石行微创经皮肾镜取石术(MPCNL),手术均获成功。术中、术后无严重不良反应发生。结论综合应用各种腔内治疗技术,小儿尿路结石可以实现现代微创治疗,并可作为一线治疗的选择。
Objective To investigate the clinical value of minimally invasive treatment of pediatric urolithiasis. Methods 79 cases of pediatric urolithiasis underwent minimally invasive endovascular treatment. 47 males and 32 females. Age 0.5 to 14 years, mean 7.9 years. Kidney stones in 18 cases; upper ureteral calculi in 14 cases (negative stones and multiple stones in 1 case), ureteral stones in 2 cases, lower ureteral calculi in 10 cases, intravesical ureter cyst in 1 case of stone, kidney stones combined with upper ureteral calculi 4 cases; bladder stones in 18 cases; urethral stones in 12 cases (6 cases of posterior urethra, anterior urethra in 6 cases). The diameter of stones is 0.5 ~ 2.8 cm and the length is 0.5 ~ 1.5 cm. Upper urinary tract stones in the left 24 cases, 22 cases of right, bilateral in 3 cases. Results Thirty cases of lower urinary tract calculi and 13 cases of middle and lower ureteral calculi underwent ureteroscopic lithotripsy (URL), 1 case of renal pelvis and 4 cases of upper ureteral calculi underwent retroperitoneal laparoscopic ureteropelvic lithotripsy (RPPL / RPUL) 31 cases of renal, upper ureteral calculi with minimally invasive percutaneous nephrolithotomy (MPCNL), the operation was successful. Intraoperative and postoperative no serious adverse reactions occurred. Conclusion Comprehensive application of a variety of endovascular therapy, pediatric urinary tract stones can achieve modern minimally invasive treatment, and can be used as a first-line treatment options.