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目的探讨2μm激光辅助部分无管化经皮肾微造瘘取石术治疗小儿肾输尿管上段结石的可行性。方法回顾性分析13例接受部分无管化经皮肾微造瘘取石术治疗的小儿肾输尿管上段结石病例,男8例,女5例,年龄6.5(3~14)岁,结石直径2.6(1.3~3.2)cm。超声引导下经皮肾穿刺扩张建立F16微通道,在输尿管镜下以第四代EMS系统碎石清石,术毕将逆行插入的输尿管导管头端调整到肾盂中部,缓慢撤镜并以2μm激光对经皮肾通道彻底止血,缝合造瘘口,观察其临床效果。结果 13例顺利完成手术,术后无明显并发症,如期出院。结论在严格掌握适应证的情况下,经皮肾微造瘘取石术治疗小儿肾输尿管上段具有疗效确切、出血少、损伤小等优点,应用2μm激光止血的部分无管化方案可进一步提高手术安全性、减轻术后不适感,加快恢复进程。
Objective To investigate the feasibility of 2 μm laser-assisted partial percutaneous nephrostomy in the treatment of upper ureteral calculi in children. Methods Retrospective analysis of 13 cases of upper ureteral calculi in children undergoing partial tubeless percutaneous nephrostomy was performed. There were 8 males and 5 females, aged 6.5 (3 to 14 years) with a diameter of 2.6 (1.3 ~ 3.2) cm. Ultrasound-guided percutaneous nephrolithotomy to establish F16 microchannel in the fourth generation of ureteroscopic ureteral gravel lithotripsy, surgery will be retrograde retrograde catheterization of the ureter to the middle of the renal pelvis, slowly remove the mirror and 2μm laser Percutaneous renal thorough hemostasis, suture stoma, observe its clinical effect. Results 13 cases successfully completed the operation, no significant complications, scheduled discharge. Conclusion In the strict indications, percutaneous nephrostomy lithotripsy of the upper ureteral ureter has the advantages of definite effect, less bleeding, less damage, the use of 2μm laser hemostasis can be part of the program to further enhance the safety of surgery Sex, reduce postoperative discomfort, speed up the recovery process.