Tong Fangyun,Zhao Yaowang,Liu Li,et al.Efficacy analysis of extracorporeal shock wave lithotripsy combined with tail-thread DJ stent placement in the treatment of pediatric renal calculi[J].Journal of Clinical Pediatric Surgery,2025,(07):683-686.[doi:10.3760/cma.j.cn101785-202503015-015]
体外冲击波碎石术联合带尾线DJ管留置治疗儿童肾结石的疗效分析
- Title:
- Efficacy analysis of extracorporeal shock wave lithotripsy combined with tail-thread DJ stent placement in the treatment of pediatric renal calculi
- Keywords:
- Kidney Calculi; Extracorporeal Shockwave Therapy; Urinary Tract; Surgical Procedures; Operative; Child
- 摘要:
- 目的 初步探讨体外冲击波碎石术联合带尾线DJ管留置治疗儿童肾结石的临床疗效。方法 回顾性分析2019年1月至2024年11月湖南省儿童医院泌尿外科收治的44例肾结石患儿临床资料,患儿均采用体外冲击波碎石术(extracorporeal shock wave lithotripsy,ESWL)联合带尾线DJ管留置治疗。收集患儿单次手术的结石清除率(stone-free rate,SFR)及术后血尿、发热等并发症发生情况。结果 44例患儿中,33例首次治疗后肾结石被完全粉碎,结石清除率为75%(33);11例(25%)存在结石残留,后续接受了第二次输尿管镜碎石取石术。24例术后出现血尿,24~36 h后自行消失;6例术后出现发热,考虑泌尿系感染,予抗感染治疗后体温恢复正常。12例完成结石成分分析,其中一水草酸钙结石10例、尿酸氢铵结石1例、碳酸磷灰石混合羟基磷灰石1例。术后随访3个月至3年,无一例结石复发。结论 体外冲击波碎石术治疗儿童肾结石安全、有效,带尾线DJ管留置可扩张输尿管,利于结石排出。
- Abstract:
- Objective To preliminarily explore the clinical efficacy of extracorporeal shock wave lithotripsy (ESWL) in treating pediatric renal calculi. Methods A retrospective analysis was conducted on the clinical data of 44 children with renal calculi treated at the Department of Urology,Hunan Children’s Hospital,between January 2019 to November 2024.All 44 patients underwent ESWL combined with tail-thread DJ stent placement.The stone-free rate (SFR) after a single procedure and postoperative complications such as hematuria and fever were recorded. Results After the first ESWL session,33 patients achieved complete stone fragmentation,yielding an SFR of 75% (33/44).The remaining 11 cases (25%) had residual stones and subsequently underwent ureteroscopic lithotripsy.Postoperatively,24 children experienced hematuria,which resolved spontaneously within 24-36 hours.6 children developed fever due to presumed urinary tract infection,and all returned to normal temperature after anti-infective therapy.Stone composition analysis was performed in 12 cases:calcium oxalate monohydrate in 10,ammonium urate in 1,and carbonate apatite mixed with hydroxyapatite in.During a follow-up of 3 months to 3 years,no stone recurrence was observed. Conclusions ESWL is a safe and effective treatment for pediatric renal calculi.Tail-thread DJ stent placement aids in ureteral dilation and facilitates stone expulsion.
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备注/Memo
收稿日期:2025-3-5。
基金项目:国家自然科学基金(82203414);湖南省卫生健康委科研计划项目(B202304057979);湖南省儿童泌尿生殖疾病临床医学研究中心(2021SK4017);湖南省自然科学基金(2023JJ40347)
通讯作者:赵夭望,Email:yw508@xinlang.com