Pediatric Diagnosis And Treatment Of Urinary Stones And Three Of The Comparison Of The Minimally Invasive Treatment

Objective:Analysis on pediatric clinical characteristics of urinary stones, discuss extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy with ureteroscopy lithotripsy via the curative effect of contrast. Methods:In our hospital from July2011to July2013,180cases of urinary stones on the patient’s clinical data were retrospectively analyzed, both by urinary tract ultrasound preoperatively, spiral CT scan, intravenous urography imaging IVP check diagnose, etc, without ureteral stricture and abnormal renal function. It by extracorporeal shock wave lithotripsy (ESWL) treatment, percutaneous nephroscope lithotripsy (PCNL) therapy and the ureter mirror nephrolithotomy (URL) is divided into three groups, each60cases. Three groups of average age (15.23+3.69) months, respectively,(16.34+2.70) months and (14.53+2.54) months; Stone of average size, respectively (18.33+2.51) mm, soil (22.3222.32) mm, and21.20+/-3.43mm. Compare three groups of calculi clearance rate, operation time, hospital total time and postoperative complications. Results:PCNL group of60cases of calculi clearance rate was98.3%(59/60); The average time (86.30+20.4) min; The average length of hospital stay (9.15+3.80) d; Postoperative fever in4cases (6.7%); ESWL group of60cases of children with one stone clearance rate36.67%(22/60),35cases with secondary gravel, total clearance rate76.7%(46/60); The average time (20.10+5.1) min; The average length of hospital stay (6.04+2.30) d; Complications of10cases (16.7%), URL group60cases calculi clearance rate95%(57/60), the average operation time (46.30+7.4) min; The average length of hospital stay (5.15+1.80) d; Postoperative fever in3patients (5.0%). After statistics processing clear stone rate of PCNL group was obviously higher than that of ESWL group, the difference was statistically significant (P<0.05); PCNL group regardless of the stone size, operating time significantly longer than ESWL group, the difference was statistically significant (P<0.05); Complications of PCNL group was obviously less than ESWL group (P<0.05); The length of hospital stay PCNL group was obviously longer than ESWL group.Conclusion:URL and PCNL compared with ESWL, two kinds of treatment methods is more than20mm on pediatric urinary stones clearance significantly higher, repeat treatment rates low, fewer complications, and compared with PCNL, URL treatment of calculi clearance rate were similar, but the operation time and hospitalization time significantly lower, so the URL of this technique can be used as first choice. Line when the following condition, can consider PCNL treatment:(1) stone is too large and is located in the section,(2) the distal ureteral stricture seriously,(3) caused by calculi obstruction for a long time proximal clear water, stones above ureteral expansion.