一期输尿管双J管置入联合体外冲击波碎石治疗婴儿上尿路多发结石

发布时间：2018-03-16 23:05

本文选题：婴儿　切入点：上尿路结石　出处：《中国微创外科杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨一期输尿管双J管置入联合体外冲击波碎石(extracorporeal shock wave lithotripsy,ESWL)治疗婴儿上尿路多发结石的安全性及有效性。方法 2013年1月~2015年6月我科对22例婴儿上尿路多发结石行一期输尿管双J管置入联合ESWL,全麻下经F6或F8膀胱镜置入输尿管双J管(F3或F4.6)后转运至碎石室,麻醉状态下行ESWL(电压7.5~10 k V,冲击波频率70次/min)。结果 22例手术均一期顺利完成,术中无输尿管穿孔、输尿管黏膜撕脱发生,术后未发生泌尿系感染、尿源性脓毒血症、肾被膜下血肿、输尿管狭窄等严重并发症。术后2~4周结石均完全排出(平均排石时间3.5周),排石率100%。术后随访观察12个月,1例患儿术后1年复查发现肾结石复发,行ESWL清除结石,其余无结石复发,泌尿系超声或CT未见肾脏及输尿管形态改变,肾功能无异常。结论一期留置输尿管双J管联合ESWL治疗婴儿上尿路多发结石,可有效减少手术次数,减少腔内侵入性有创操作,安全有效,值得临床推广。
[Abstract]:Objective to explore the issue of double J ureteral implantation combined with extracorporeal shock wave lithotripsy (extracorporeal shock wave lithotripsy, ESWL) in treating infantile upper urinary tract lithiasis of the safety and effectiveness of the method. In January 2013 ~2015 year in June in our department, 22 cases of infant urinary tract lithiasis underwent a double J ureteral implantation combined with ESWL after F6 or F8 tube, double J ureteral cystoscope implantation under general anesthesia (F3 or F4.6) after transfer to the stone manipulation room, anesthesia (ESWL 7.5~10 K V voltage, shock wave frequency 70 /min). The results of 22 cases of surgery were successfully completed, no ureteral perforation, ureteral mucosa avulsion, surgery no incidence of urinary tract infection, urinary derived sepsis, renal subcapsular hematoma, ureteral stenosis and other serious complications. 2~4 weeks after stones were completely discharged (mean expulsion time 3.5 weeks), the stone expulsion rate after 100%. 12 months of follow-up, 1 cases of postoperative 1 In the review found that the recurrence of kidney stone, ESWL removal of stones, no other changes of urinary calculi recurrence, ultrasound or CT no kidney and ureter form, renal function abnormalities. Conclusion a period of indwelling double J ureteral combined with ESWL in treating infantile upper urinary tract lithiasis, can effectively reduce the operation time, reduce the invasive cavity invasive, safe and effective, worthy of promotion.

【作者单位】：河北省儿童医院泌尿外科;河北省石家庄市第三医院超声医学科;首都医科大学基础医学院;
【基金】：河北省2015年医学科学重点研究计划(20150554)
【分类号】：R726.9

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