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儿童膀胱结石的经皮膀胱碎石术:病例系列,来自一家三级医院的经验

Percutaneous cystolithotripsy of bladder stones in children: A case series, an experience from a tertiary hospital.

作者信息

Ismy Jufriady, Asnafi Arie, Pratama Rovy

机构信息

Department of Urology, Faculty of Medicine, Zainoel Abidin Hospital, Universitas Syiah Kuala, Banda Aceh, Indonesia.

Department of Urology, Faculty of Medicine, Hasan Sadikin General Hospital, Universitas Padjajaran, Bandung, Indonesia.

出版信息

Urol Ann. 2022 Jan-Mar;14(1):85-88. doi: 10.4103/UA.UA_177_20. Epub 2022 Jan 20.

DOI:10.4103/UA.UA_177_20
PMID:35197709
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8815350/
Abstract

Urinary calculus is more commonly known in infants, and the urinary bladder is the most common location in the lower urinary tract for stone formation. There are three basic types of bladder calculus: Primary idiopathic/endemic, secondary, and migrant. The standard treatment of bladder calculus is open cystolithotomy or transurethral cystolitholapaxy. However, the use of a percutaneous approach has been promoted. We performed percutaneous cystolithotripsy with urethrocystoscopy guidance in children with bladder stones. The procedure was done without any ultrasound or fluoroscopic guidance. In children who required percutaneous cystolithotripsy with urethrocystoscopy guidance, we documented four cases of bladder stones. The diagnoses were made based on anamnesis, ultrasonography, physical examination, and X-ray imaging. In all patients, the operation was successful, and intraoperative results showed a single stone in each of the three patients and two stones in the same patient. This report aims to define the surgical challenges presented by bladder stones and the multidisciplinary approach needed to deal with them. Under ultrasound or fluoroscopic guidance, we performed percutaneous cystolithotripsy in children. The percutaneous cystolithotripsy was the most frequent outpatient treatment. The bladder was first filled with contrast material or water. A Foley catheter was inserted in the urethra and left for a period of 3-5 days. The rectus fascia defect was closed using the 2-0 vicryl suture. Percutaneous suprapubic lithotripsy is a safe and successful procedure for treating bladder stones in children. It is fast and linked to negligible complications.

摘要

小儿膀胱结石较为常见,膀胱是下尿路结石形成最常见的部位。膀胱结石有三种基本类型:原发性特发性/地方性、继发性和迁移性。膀胱结石的标准治疗方法是开放性膀胱切开取石术或经尿道膀胱碎石术。然而,经皮治疗方法已得到推广。我们在膀胱结石患儿中采用尿道膀胱镜引导下经皮膀胱碎石术。该手术无需任何超声或荧光透视引导。在需要尿道膀胱镜引导下经皮膀胱碎石术的患儿中,我们记录了4例膀胱结石病例。诊断依据病史、超声检查、体格检查和X线成像做出。所有患者手术均成功,术中结果显示,3例患者各有1枚结石,1例患者有2枚结石。本报告旨在明确膀胱结石带来的手术挑战以及应对这些挑战所需的多学科方法。在超声或荧光透视引导下,我们对患儿实施了经皮膀胱碎石术。经皮膀胱碎石术是治疗小儿膀胱结石最常用的门诊治疗方法。首先向膀胱内注入造影剂或水。经尿道插入Foley导尿管并留置3 - 5天。用2 - 0可吸收缝线关闭腹直肌筋膜缺损。经皮耻骨上膀胱碎石术是治疗小儿膀胱结石的一种安全、成功且快速的手术,并发症极少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17f2/8815350/359c8b91bc51/UA-14-85-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17f2/8815350/ebf21e34fd6b/UA-14-85-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17f2/8815350/db13f4396e1a/UA-14-85-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17f2/8815350/530198e09a58/UA-14-85-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17f2/8815350/359c8b91bc51/UA-14-85-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17f2/8815350/ebf21e34fd6b/UA-14-85-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17f2/8815350/db13f4396e1a/UA-14-85-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17f2/8815350/530198e09a58/UA-14-85-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17f2/8815350/359c8b91bc51/UA-14-85-g004.jpg

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本文引用的文献

1
Chemical Composition Of Stones In Paediatric Urolithiasis.小儿尿路结石的化学成分
J Ayub Med Coll Abbottabad. 2017 Oct-Dec;29(4):630-634.
2
Bladder stones after bladder augmentation are not what they seem.膀胱扩大术后出现的膀胱结石并非表面看上去那么简单。
J Pediatr Urol. 2016 Apr;12(2):98.e1-6. doi: 10.1016/j.jpurol.2015.06.021. Epub 2015 Sep 25.
3
Percutaneous treatment of bladder stones in children: 10 years experience, is blind access safe?儿童膀胱结石的经皮治疗:10年经验,盲目穿刺入路是否安全?
Pediatr Surg Int. 2013 Jul;29(7):725-8. doi: 10.1007/s00383-013-3320-x. Epub 2013 May 7.
4
Changes in urinary stone composition in the Tunisian population: a retrospective study of 1,301 cases.突尼斯人群中尿石成分的变化:一项回顾性研究,涉及 1301 例病例。
Ann Lab Med. 2012 May;32(3):177-83. doi: 10.3343/alm.2012.32.3.177. Epub 2012 Apr 18.
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Operative management of pediatric urolithiasis.小儿尿路结石的手术治疗
Indian J Urol. 2010 Oct;26(4):536-43. doi: 10.4103/0970-1591.74454.
6
Percutaneous suprapubic cystolithotripsy approach: for whom? Why?经皮耻骨上膀胱碎石术:适用于谁?为何适用?
J Endourol. 2006 Jun;20(6):429-31. doi: 10.1089/end.2006.20.429.