Brisson Paul, Woll Michael, Parker David, Durbin Ronald
Department of Surgery, Fort Belvoir Community Hospital, 9300 DeWitt Loop, Fort Belvoir, VA 22060, USA.
Mil Med. 2012 Nov;177(11):1403-5. doi: 10.7205/milmed-d-12-00035.
Military surgeons have been providing humanitarian care in Afghanistan since 2002. There are scant published reports on the details of that care. We report here the experience of deployed U.S. Army general surgeons in the management of an endemic problem, bladder stones in Afghan children.
A retrospective review was performed of pediatric patients presenting to an International Security Assistance Force humanitarian clinic over a 12-month period from October 2010 to November 2011. Symptoms at presentation, diagnostic modalities, and treatment provided were analyzed. The general surgeons of the 126th Forward Surgical Team (FST) provided surgical consultations for this military humanitarian clinic on a remote base in western Afghanistan.
Eight male pediatric patients of an average age of 4 years presented with dysuria and underwent further evaluation. In five patients, the use of a portable ultrasound machine led to the diagnosis of bladder stones. Three other patients presented with ultrasound exams from an Afghan clinic. Four patients underwent surgical removal of their bladder stones by the FST and 4 four patients, including one with a recurrent bladder stone, were referred to a distant Afghan Regional Hospital. No short-term complications occurred in the five patients available for follow-up.
Military surgeons providing humanitarian care in rural areas of Afghanistan, and humanitarian surgeons serving in endemic areas, can expect to encounter multiple cases of bladder stones in pediatric patients. Dysuria is a typical presenting symptom. The FST has the resources to diagnose and treat this disorder. If accessible, Afghan regional hospitals can provide curative surgery.
自2002年以来，军事外科医生一直在阿富汗提供人道主义医疗服务。关于该医疗服务细节的公开报道很少。我们在此报告部署在阿富汗的美国陆军普通外科医生在处理一个地方病问题——阿富汗儿童膀胱结石方面的经验。
对2010年10月至2011年11月这12个月期间到国际安全援助部队人道主义诊所就诊的儿科患者进行回顾性研究。分析就诊时的症状、诊断方式及所提供的治疗。第126前方外科团队（FST）的普通外科医生为阿富汗西部偏远基地的这个军事人道主义诊所提供手术会诊。
8名平均年龄4岁的男性儿科患者出现排尿困难并接受了进一步评估。5名患者通过便携式超声机诊断为膀胱结石。另外3名患者提供了来自阿富汗诊所的超声检查结果。4名患者由FST进行了膀胱结石手术切除，4名患者，包括1名复发性膀胱结石患者，被转诊至较远的阿富汗地区医院。5名可进行随访的患者未发生短期并发症。
在阿富汗农村地区提供人道主义医疗服务的军事外科医生以及在地方病流行地区服务的人道主义外科医生，可能会遇到多例儿科患者膀胱结石病例。排尿困难是典型的就诊症状。FST有诊断和治疗这种疾病的资源。如果能够前往，阿富汗地区医院可提供根治性手术。
