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1、小儿尿路结石的腔内微创治疗[摘要]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例小儿尿路结石患者施行腔内微创治疗。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&m,长径0.5〜1.5cm。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
2、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。[关键词]尿结石;内窥镜;微创外科手术Themini-invasiveendoscopictherapyforthepediatricurolithiasis:reportof79casesZOUXiao-feng,YUANYuan-hu,XIAORi-hai.et
3、al.DepartmentofUrology,FirstAffiliatedHospitalofGannanMedicalcollege,JiangXi,Ganzhou341000,ChinaIAbstract]ObjectiveToinvestigatetheclinicalvalueofendoscopictherapytothepediatricurolithiasis・MethodsAtotal79caseswithurolithiasiswereunderwentendoscopictherapy(47weremale,32werefemale
4、andagerangewas0.5-14years,averagewas7.9years).Ofthem,18caseswithrenalcalculi;14caseshadcalculiintheproximalpartoftheureter(each1negativecalculiandexcessivecalculi),2inthemiddlepartand10inthedistalpart;1patientwiththecalculiintheintravasicalureteralcyst;4caseshadcalculiinkidneyand
5、theproximalpartoftheureter;18caseswithvesicalcalculiand12caseswithurethralcalculi(each6casesintheanteriorurethraandposteriorurethra).Thesizeofthecalculi5swidthrangewas0.5〜2.8cmandlengthrangewas0.5〜1.5cm.24caseswereleft,22caseswererightand3caseswerebothsideintheupperurinarytract.R
6、esultsTheureterorenolithotripsywasperformedon30caseswithdownurinarytractcalculiand13caseswiththecalculiinthemiddlepartanddistalpart;theretroperitoneoscopicpyelolithotomy(ureterolithotomy)wasperformedon1casewithpelviccalculiand4caseswithcalculiintheproximalpartoftheureterwhile31ca
7、seswithcalculiinthekidneyandproximalpartoftheureterwereunderwentthemini-invasivepercutaneousnephrolithotomysuccessfully.Therewasnoseverecomplicationshappenedintheoperationandpostoperation.ConclusionsThemodemmini-invasivetherapycanbeachievedtothepediatricurolithiasiswithsynthesizi
8、ngallsortsofendoscopictechnologiesanditc