经皮膀胱肾镜治疗小儿膀胱结石

J4 ›› 2013, Vol. 12 ›› Issue (3): 42-44.

经皮膀胱肾镜治疗小儿膀胱结石

大理学院附属医院，云南大理 671000

收稿日期:2012-10-09 出版日期:2013-03-15 发布日期:2013-03-15
作者简介:杨立，讲师，主要从事泌尿外科研究.

Percutaneous Cystolithotomy for Pediatric Bladder Stone

Affiliated Hosptial of Dali University, Dali, Yunnan 671000, China

Received:2012-10-09 Online:2013-03-15 Published:2013-03-15

摘要/Abstract

摘要：

目的：探讨经皮膀胱肾镜碎石术在小儿膀胱结石中的应用。方法：对15例小儿膀胱结石患者的临床治疗资料进行回顾性
分析。其中患儿年龄4~9（6.6±1.57）岁，膀胱结石直径1.3~3.7（2.6±0.92）cm；行耻骨上膀胱穿刺建立经皮膀胱通道，用钬激光或气压弹道击碎膀胱结石，视术中情况留置尿管。结果：所有患儿均获手术成功，手术时间20~45（32.5±6.43）min。术后早期5例患儿因留置尿管感尿道疼痛，无明显严重并发症出现。随访6~12个月，所有患儿均排尿通畅，无尿道狭窄和结石复发。结论：经皮膀胱肾镜治疗小儿膀胱结石具有安全、有效，结石清除率高等优点，可有效避免经尿道手术所致的术中技术风险、术后结石残留和尿道狭窄。

关键词: 小儿膀胱结石, 微通道, 经皮膀胱肾镜碎石

Abstract:

Objective: To evaluate the application of percutaneous cystolithotomy in pediatric bladder stone. Methods: Fifteen boys with a mean age of 4-9（6.6±1.57）years and mean stone diameter at 1.3-3.7（2.6±0.92）cm underwent percutaneous cystolithotomy. Patients were punctureed into the bladder above suprapubic for establish the percutaneous bladder channel, then the bladder stones were smashed with the methods of holmium laser lithotripsy or pneumatic ballistic lithotripsy. The indwelling catheter was implanted according to intraoperative situation. Total 15 cases of clinical data were conducted with retrospective analysis. Results: All 15 patients were operated successfully and the mean procedure time was 20~45（32.5±6.43）min. Five cases felt pain because of indwelling catheter but there were no severe complications occurred. During 6~12 months follow-up, there were no difficulties in urinating, no urethral stricture, and no stone recurrence. Conclusion: Percutaneous cystolithotomy is an effective therapy in the treatment of pediatric bladder stones, which is with less trauma, high stone removal rate. The therapy can avoid the risks induced by transurethral technique such as urethral mucosal damage, postoperative residual stones and urethral stricture.

Key words: pediatric bladder stone, microchannel, percutaneous cystolithotomy

中图分类号:

R694.4

杨立, 萧芝松, 郑宝寿, 文贵成. 经皮膀胱肾镜治疗小儿膀胱结石[J]. J4, 2013, 12(3): 42-44.

YANG Li, XIAO Zhi-Song, ZHENG Bao-Shou, WEN Gui-Cheng. Percutaneous Cystolithotomy for Pediatric Bladder Stone[J]. J4, 2013, 12(3): 42-44.

参考文献

〔1〕Papatsoris A G，Varkarakis I，Dellis A，et al.Bladder lithiasis：
from open surgery to lithotripsy〔J〕.Urol Res，2006，34（3）：
163-167.
〔2〕Vanwaeyenbergh J，Vergauwe D，Verbeeck R M.Infrared
spectrometric analysis of endemic bladder stones in Niger
〔J〕.Eur Urol，1995，27（2）：154-159.
〔3〕Sun X，Shen L，Cong X，et al.Infrared spectroscopic analysis
of urinary stones （including stones induced by melaminecontaminated
milk powder）in 189 Chinese children〔J〕.J
Pediatr Surg，2011，46（4）：723-728.
〔4〕Alaya A，Najjar M F，Nouri A.Changes in stone composition
according to age in Tunisian pediatric patients〔J〕.Int Urol
Nephrol，2010，42（3）：621-628.
〔5〕Al-Marhoon M S，Sarhan O M，Awad B A，et al. Comparison
of endourological and open cystolithotomy in the
management of bladder stones in children〔J〕. J Urol，
2009，181（6）：2684-2687.
〔6〕Isen K，Em S，Kilic V，et al.Management of bladder stones
with pneumatic lithotripsy using a ureteroscope in children
〔J〕.J Endourol，2008，22（5）：1037-1040.
〔7〕Agrawal M S，Aron M，Goyal J，et al. Percutaneous suprapubic
cystolithotripsy for vesical calculi in children〔J〕. J Endourol，
1999，13（3）：173-175.
〔8〕Salah M A，Holman E，T佼th C.Percutaneous suprapubic
cystolithotripsy for pediatric bladder stones in a developing
country〔J〕.Eur Urol，2001，39（4）：466-470.
〔9〕Rattan K N，Bhatia V，Ratan S K，et al.Catheterless and
drainless open suprapubic cystolithotomy in children：a
safe procedure〔J〕.Pediatr Surg Int，2006，22（3）：255-258.
〔10〕Gan W，Guo H，Yang R，et al.Minimally invasive
percutaneous cystolithotomy：an effective treatment for
bladder stones in infants aged <1 year 〔J〕. BJU Int，
2010，106（2）：275-277.
〔11〕BarberTD，DajustaD，GargolloPC.Outpatient percutaneous
cystolithotomy following complex lower urinary tract
reconstruction〔J〕. J Pediatr Urol，2012，6：30.
〔12〕Rhee A C，Cain M P. Percutaneous cystolithotomy in the
pediatric neuropathic bladder with laparoscopic trocar
access：A modified approach useful for the augmented
and native bladder，and continent urinary reservoir〔J〕.J
Pediatr Urol，2012，7：12.
〔13〕Ramakrishnan P A，Medhat M，Al-Bulushi Y H，et al.
Holmium laser cystolithotripsy in children： initial
experience〔J〕. Can J Urol，2005，12（6）：2880-2886.