超微型经皮肾镜取石术与微型经皮肾镜取石术治疗儿童肾结石的比较

Q4 Medicine

中华小儿外科杂志 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2020.03.012

X. Zhan, Daniel Wang, Jianguo Zhu, Jin-pu Peng, Moudong Wu, Feng-ju Lu, Guoqing He, Nini An

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Operative duration, primary stone clearance rate, postoperative complications and other parameters of two groups were statistically analyzed for comparing the characteristics of two operative approaches. \n \n \nResults \nThe time of establishing percutaneous renal channel was shorter in SMP group than that in MPCNL group [(10.75±2.70) vs. (19.68±6.95) min]. And inter-group difference was statistically significant (P=0.016). The first-phase stone clearance, postoperative hemoglobin loss and postoperative complication rate of SMP and MPCNL groups were (83.33±46.72) vs. (101.36±38.91) min, 83.33% vs. 81.81% and (7.59±7.51) vs. (7.75±8.77) g/L. respectively. No significant inter-group difference existed. No blood transfusion was provided. In SMP group, there was Clavien Ⅰ complication (n=1, 5.55%); In MPCNL group (n=5, 22.72%), postoperative fever subsided after aggressive anti-infection treatment. In two groups, there was on onset of Clavien Ⅱ/Ⅲ complications. 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引用次数: 0

摘要

目的比较超微型经皮肾镜取石术(SMP)与微型经皮肾镜取石术(MPCNL)治疗儿童肾结石的安全性和有效性。方法回顾性分析40例小儿肾结石的临床资料。分别行SMP (n=18)和MPCNL (n=22)。SMP组男14例，女4例，年龄(7.90±4.40)岁，结石大小(15.41±5.63)mm;MPCNL组男14例，女8例，年龄(8.62±3.41)岁，结石大小(16.77±3.59)mm。统计分析两组手术时间、原发结石清除率、术后并发症等参数，比较两种手术入路的特点。结果SMP组经皮肾道建立时间明显短于MPCNL组[(10.75±2.70)min vs(19.68±6.95)min]。组间差异有统计学意义(P=0.016)。SMP组和MPCNL组一期结石清除率、术后血红蛋白损失及术后并发症发生率分别为(83.33±46.72)vs(101.36±38.91)min、83.33% vs 81.81%、(7.59±7.51)vs(7.75±8.77)g/L。分别。组间差异不显著。没有输血。SMP组出现ClavienⅠ并发症(n=1, 5.55%);MPCNL组(5例，22.72%)术后发热经积极抗感染治疗后消退。两组均未出现ClavienⅡ/Ⅲ并发症。超声随访1 ~ 2年，两组均无肾积水或肾萎缩。结论SMP和MPCNL治疗小儿肾结石安全、有效、微创。与MPCNL相比，SMP具有更小的通道和更薄的镜体。而SMP更适合于肾萼颈狭窄、下肾盏结石的婴幼儿。关键词:肾结石;经皮肾镜取石术;孩子

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Comparison of super-mini-percutaneous nephrolithotomy versus mini-percutaneous nephrolithotomy for renal calculi in children

Objective To compare the safety and efficacy of super-mini-percutaneous nephrolithotomy (SMP) versus mini-percutaneous nephrolithotomy (MPCNL) in managing renal calculi in children. Methods Medical records were retrospectively reviewed for 40 children with renal calculi. They underwent SMP (n=18) and MPCNL (n=22). In SMP group, there were 14 boys and 4 girls with an age range of (7.90±4.40) years and a stone size of (15.41±5.63) mm; In MPCNL group, there were 14 boys and 8 girls with an age range of (8.62±3.41) years and a stone size of (16.77±3.59) mm. Operative duration, primary stone clearance rate, postoperative complications and other parameters of two groups were statistically analyzed for comparing the characteristics of two operative approaches. Results The time of establishing percutaneous renal channel was shorter in SMP group than that in MPCNL group [(10.75±2.70) vs. (19.68±6.95) min]. And inter-group difference was statistically significant (P=0.016). The first-phase stone clearance, postoperative hemoglobin loss and postoperative complication rate of SMP and MPCNL groups were (83.33±46.72) vs. (101.36±38.91) min, 83.33% vs. 81.81% and (7.59±7.51) vs. (7.75±8.77) g/L. respectively. No significant inter-group difference existed. No blood transfusion was provided. In SMP group, there was Clavien Ⅰ complication (n=1, 5.55%); In MPCNL group (n=5, 22.72%), postoperative fever subsided after aggressive anti-infection treatment. In two groups, there was on onset of Clavien Ⅱ/Ⅲ complications. Ultrasonic follow-ups were conducted for 1-2 years and hydronephrosis or renal atrophy disappeared in both groups. Conclusions Both SMP and MPCNL are safe, effective and mini-invasive for pediatric renal calculi. As compared with MPCNL, SMP has a smaller channel and a thinner mirror body. And SMP is more suitable for infants or toddlers with narrow calyx neck and lower calyx calculi. Key words: Renal calculus; Percutaneous nephrolithotomy; Child

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来源期刊

中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.40

自引率

0.00%

发文量

8707

期刊介绍： Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.