Department of Urology and Pharmacy, Drum Tower Hospital, Nanjing University, Nanjing, China.
J Urol. 2010 Aug;184(2):665-8. doi: 10.1016/j.juro.2010.03.060. Epub 2010 Jun 19.
We evaluated the efficacy and safety of shock wave lithotripsy in the supine position through the greater and lesser ischiadic foramina as a path of shock wave to treat distal ureteral stones in young children.
We treated 22 young children with distal urinary calculi using the Dornier Compact S lithotriptor between 1997 and 2007. The study population consisted of 15 boys and 7 girls 6 months to 7 years old (mean +/- SD 5.4 +/- 2.1 years). Stone size ranged from 5 to 16 mm (mean 6.8). All patients were treated in the supine position under dissociative anesthesia with ketamine. The focused shock wave targeted the stone in the distal ureter through the greater and lesser ischiadic foramina.
Number of shocks ranged from 600 to 3,000 (mean +/- SD 2,346.2 +/- 483.7). Energy per pulse ranged from level 4 to 5 (mean 4.5). Treatment time varied from 20 to 40 minutes (mean 31). Stone-free rate at 2 weeks after lithotripsy was 77.3%, which increased to 100% at 3 months after a single lithotripsy session. No serious side effects were observed.
Shock wave lithotripsy in the supine position through the greater and lesser ischiadic foramina as the path of shock wave treats distal ureteral stones in young children with an excellent success rate and few side effects.
我们评估了通过坐骨大、小孔作为冲击波路径，使患者取仰卧位行体外冲击波碎石术治疗小儿输尿管下段结石的疗效和安全性。
1997 年至 2007 年，我们应用 Dornier Compact S 碎石机对 22 例小儿输尿管下段结石进行治疗。研究对象为 15 例男性和 7 例女性患儿，年龄 6 个月至 7 岁（平均 5.4 ± 2.1 岁）。结石大小 5~16mm（平均 6.8mm）。所有患儿均在分离麻醉下取仰卧位接受治疗，使用氯胺酮。冲击波聚焦于输尿管下段结石，通过坐骨大、小孔进入。
碎石冲击次数 6003000 次（平均 2346.2 ± 483.7 次），单脉冲能量 45 级（平均 4.5 级），治疗时间 20~40 分钟（平均 31 分钟）。碎石后 2 周结石清除率为 77.3%，单次碎石后 3 个月时增至 100%。无严重并发症发生。
仰卧位经坐骨大、小孔入路行体外冲击波碎石术治疗小儿输尿管下段结石，成功率高，副作用少。
