输尿管软镜和Microperc治疗婴幼儿≤2 cm肾结石的疗效比较

王磊, 王文营, 张彩祥, 等. 输尿管软镜和Microperc治疗婴幼儿≤2 cm肾结石的疗效比较[J]. 临床泌尿外科杂志, 2019, 34(4): 259-263. doi: 10.13201/j.issn.1001-1420.2019.04.003
引用本文: 王磊, 王文营, 张彩祥, 等. 输尿管软镜和Microperc治疗婴幼儿≤2 cm肾结石的疗效比较[J]. 临床泌尿外科杂志, 2019, 34(4): 259-263. doi: 10.13201/j.issn.1001-1420.2019.04.003
WANG Lei, WANG Wenying, ZHANG Caixiang, et al. Comparison of the efficiency between flexible ureteroscopy and Microperc in the treatment of kidney stones less than 2 cm in infants[J]. J Clin Urol, 2019, 34(4): 259-263. doi: 10.13201/j.issn.1001-1420.2019.04.003
Citation: WANG Lei, WANG Wenying, ZHANG Caixiang, et al. Comparison of the efficiency between flexible ureteroscopy and Microperc in the treatment of kidney stones less than 2 cm in infants[J]. J Clin Urol, 2019, 34(4): 259-263. doi: 10.13201/j.issn.1001-1420.2019.04.003

输尿管软镜和Microperc治疗婴幼儿≤2 cm肾结石的疗效比较

  • 基金项目:

    北京市科技计划课题(编号Z151100004015106)

    北京市医院管理局临床医学发展专项经费资助(编号XMLX201826)

    北京友谊医院科研启动基金(编号yyqdkt2015-14)

详细信息
    通讯作者: 李钧,E-mail:lijun@yeah.net
  • 中图分类号: R692.4

Comparison of the efficiency between flexible ureteroscopy and Microperc in the treatment of kidney stones less than 2 cm in infants

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  • 目的:比较输尿管软镜和Microperc治疗婴幼儿≤2 cm肾结石的安全性和有效性。方法:回顾性分析2016年10月~2017年10月在我院行输尿管软镜和Microperc手术治疗婴幼儿肾结石的临床资料,依据手术方式分为两组。输尿管软镜组共38例,男25例,女13例,年龄(19.6±9.9)个月,结石最大直径(13.7±4.5) mm,结石数量(1.29±0.57)个。Microperc组共29例,男19例,女10例,年龄(20.7±10.6)个月,结石最大直径(13.9±4.5) mm,结石数量(1.31±0.54)个。所有患儿提前2周留置4.7Fr双J管。输尿管软镜采用全身麻醉,截石位。经输尿管硬镜拔除双J管。使用14G套管针行耻骨上膀胱穿刺造瘘。使用POLY组合式小儿输尿管软镜经导丝进入输尿管和肾盂内,注射器手动推水保持视野清晰,200μm钬激光光纤碎石。Microperc手术采用全身麻醉,留置尿管,俯卧位。B超引导下可视穿刺设备对目标肾盏行经皮肾穿刺建立操作通道。注射器手动推水保持视野清晰,200μm钬激光光纤碎石。结果:输尿管软镜组共进行41次(47侧)肾结石手术;Microperc组共进行32次(37侧)肾结石手术。输尿管软镜组手术时间(38.1±16.5) min,灌注液用量(193±117) ml,术后住院天数(2.45±1.05) d,完全清石率73.17%,并发症发生率34.1%;Microperc组手术时间(40.6±22.7) min,灌注液用量(210±133) ml,术后住院天数(2.29±0.92) d,完全清石率81.25%,并发症发生率15.6%,两组比较差异无统计学意义。输尿管软镜组术后第2天血红蛋白下降(0.48±0.26) g/dl,灌注量-引流量(49.5±43.4) ml;Microperc组术后第2天血红蛋白下降(0.65±0.33) g/dl,灌注量-引流量(20.8±13.6) ml,两组比较差异有统计学意义。结论:输尿管软镜和Microperc技术治疗婴幼儿≤2 cm肾结石均具有较高的安全性和有效性,但Microperc技术并发症发生率更低。
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出版历程
收稿日期:  2018-11-06

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