微创经皮肾穿刺取石治疗小儿上尿路结石

目的探讨微创经皮肾穿刺取石术（minimally invasive percutaneous nephrolithotomy,MPCNL）治疗小儿上尿路结石的效果。方法回顾分析35例MPCNL治疗小儿上尿路结石的临床资料,男29例,女6例,平均年龄8.5岁（4～13岁）。输尿管上段结石7例,肾结石28例,均为一侧上尿路结石。伴肾盂输尿管连接部（ureteropelvic junction obstruction,UPJ）梗阻2例。结果MPCNL治疗成功31例,成功率88.6%（31/35）,其中一期结石完全清除率87.1%（27/31）,二期结石完全清除率75%（3/4）。2例结石位于UPJ致结石下方狭窄,2例皮肾穿刺失败,改开放手术。结论MPCNL是治疗小儿肾结石和输尿管上段结石安全、有效的方法。

Minimally Invasive Percutaneous Nephrolithotomy for Pediatric Upper Urinary Tract Calculi

Objective To explore the safety and efficacy of minimally invasive percutaneous nephrolithotomy （MPCNL） for pediatric upper urinary tract calculi. Methods We retrospectively reviewed the clinical data of 35 pediatric patients with upper urinary tract stones treated by MPCNL in our hospital. The series consists of 29 boys and 6 girls with a mean age of 8.5 years （4 to 13 years）. Among the 35 cases,7 children had proximal ureteral stones and 28 showed renal stones, 2 of the patients were complicated with ureteropelvic junction obstruction （UPJ）. Results Totally 31 （88.6%） of the 35 cases were cured by MPCNL. The one-session success rate was 87.1% （27/31）,and two-session success rate was 75% （3/4）. Four patients were converted to open surgery because of UPJ-caused ureteral stenosis under the level of the calculi or failure in percutaneous renal puncture. Conclusion MPCNL is safe and effective for renal calculi and proximal ureteral calculi in children.