钬激光腔内治疗在小儿泌尿系统疾病的初步应用-钬激光腔内治疗小儿

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1、钦激光腔内治疗在小儿泌尿系统疾病的初步应用陈映鹤王爱和虞海峰李仲荣陈肖鸣温州医学院附属第二医院(育英儿童医院)泌丿求外科，小儿外科浙江，温州(325027)目的评价钦激光腔内治疗小儿泌尿系统疾病的方法和疗效。方法回顾2005年3月以来采用钦激光腔内治疗18例小儿泌尿系统疾病的临床资料，男12例，女6例，年龄1.0〜14岁,平均6.6岁。输尿管结石6例，上段1例、中下段5例，直径0.5〜0.9cmo后尿道及膀胱结石7例，结石直径0.8〜1.5cm。先天性单纯性输尿管口囊肿3例，直径2.0cm〜3.5cm。前、后尿道狭窄各一例，长度为0.4cm和和0.

2、5cm。进行输尿管镜和小儿膀胱镜下钦激光腔内微创治疗。结果6例输尿管镜下钦激光输尿管碎石术、7例小儿膀胱镜下钦激光膀胱结石碎石术、3例输尿管镜卜•钦激光输尿管囊肿去顶开窗术和2例尿道狭窄内切开加疤痕组织切除术均一次成功，无并发症。手术时间8〜25min,平均16mino尿道狭窄术后留置导尿管2周,住院15天；其余病人术后留置导尿管1〜3天，住院2〜5天。双“J”管术后2周拔除。结石术后随访2〜12个刀无残留和复发，原伴随的肾积水消失;输尿管口囊肿术后随访3〜9个月无膀胱输尿管返流；尿道狭窄术后1个月和3个月时各预防性尿道扩张一次，随访4〜12个月排

3、尿通畅。结论初步应用表明钦激光腔内治疗小儿泌尿系统疾病妥全、有效、微创,但需要积累更多的病例和更长时间的随访。[关键词]泌尿系疾病；内窥镜外科手术；激光TeatmentofurologicdiseaseinchildrenwithendoscopicHolmium:YAGlaserCHENYing-he,WANGAi-he,YUHai-feng,LIZhong-rong,CHENXiao-ming.DepartmentofUrologyandPediatricSurgery.TheSecondAffiliatedandYuyingChildren'

4、sHospitolofWenzhouMedicalCollege.WenzhouZhejiang325027,China.E-mail：ChenYH@wzhealth.com[Abstract]ObjectiveToevaluatethemethodandclinicalefficacywithendoscopicHolmium:YAGlaseronthetreatmentofurinarydiseaseinchildren.MethodsWereviewedthetreatmentandoutcomeof18children,6girlsand1

5、2boys,withagerangingfrom1.0to14years(mean6.6years).Oneupperureterstoneand5midandlowerureterstonewithhydronephrosis,andthestonesizerangedfrom0.5to0.9cm.Bladderstonein7casesandthestonesizerangedfrom0.8to1.5cm.Simpleureterocelein3casesthediameterfrom2.0cm〜3.5cm.OneAnteriorand1pos

6、teriorurethralstricturewithlength0.4cmand0.5cm.AllthechildrenunderwentureteroscopicorPediatriccystoscopicprocedureswithendoscopicHolmium:YAGlaser.Results6ureteroscopicand7PediatriccystoscopicHolmium:YAGlaserlithotripsys,3ureteroscopicHolmium:YAGlaserincisionforureteroceleand2p

7、rocedureforurethralstricturewereperformedsuccessfullywithoutcomplication.Operatingtimerangedfrom8to25minutes(mean16minutes).Thecasesofurethralstricturewasplacedcatheterfor14daysandstayedinwardfor15dayswhileotherpatientswereplacedcatheterfor1to3daysandstayedinwardfor2to5days.AD

8、ouble-Jstentwasinsertedafteruretero-lithotripsyandkeptfor2wee