Rodrigues Netto Nelson, Longo José Antonio, Ikonomidis Jean A, Rodrigues Netto Mauricio
Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
J Urol. 2002 May;167(5):2164-6.
We analyzed the efficacy of extracorporeal shock wave lithotripsy in children.
Between 1987 and 2000, 15,423 patients with urinary calculi were treated at our institution, of whom 86 (0.56%) children 3 to 14 years old underwent lithotripsy using the Siemens Lithostar Plus (Siemens Medical Systems, Iselin, New Jersey). A total of 121 calculi in 90 urinary tracts were treated requiring 149 extracorporeal shock wave lithotripsy sessions. The stones were caliceal in 62 cases, renal pelvic in 35, ureteral in 18 and staghorn in 6. Followup consisted of nephrotomogram or ultrasound 1 day and 1 to 3 months postoperatively.
Complete removal of all stone fragments was achieved in 97.6% of the stones after 3 months. Re-treatment was necessary in 24 patients (27.9%). All patients were treated as outpatients with intravenous sedation in 54 (62.8%), general anesthesia in 13 (15.1%) and no anesthesia in 19 (22.1%). Complications were present in 8 patients (10.7%) who had colic and received medical treatment followed by uneventful recovery.
Extracorporeal shock wave lithotripsy using the Lithostar Plus has been demonstrated to be an effective noninvasive procedure to treat radiopaque and even radiolucent or slightly opaque urinary calculi in children.
我们分析了体外冲击波碎石术在儿童中的疗效。
1987年至2000年间，我院共治疗了15423例尿路结石患者，其中86例（0.56%）3至14岁的儿童使用西门子Lithostar Plus（西门子医疗系统公司，新泽西州伊斯林）进行了碎石术。共治疗了90个尿路中的121颗结石，需要进行149次体外冲击波碎石术。结石位于肾盏的有62例，肾盂的有35例，输尿管的有18例，鹿角状结石有6例。术后1天及1至3个月通过肾断层造影或超声进行随访。
3个月后，97.6%的结石碎片完全清除。24例患者（27.9%）需要再次治疗。所有患者中，54例（62.8%）在静脉镇静下作为门诊患者接受治疗，13例（15.1%）接受全身麻醉，19例（22.1%）未接受麻醉。8例患者（10.7%）出现并发症，表现为绞痛，经治疗后康复顺利。
已证明使用Lithostar Plus进行体外冲击波碎石术是一种有效的非侵入性方法，可用于治疗儿童中的不透射线甚至透光或稍不透光的尿路结石。
