应用Turner-Warwick切口治疗小儿膀胱结石及输尿管结石的体会

目的：探讨Turner-Warwick切口治疗小儿输尿管下段结石合并膀胱结石开放手术的方法。方法：本院在2006～2010年收治的4例输尿管下段结石合并膀胱结石患儿,年龄4～8岁,平均5.8岁,其中3例男孩,1例女孩,输尿管下段结石合并膀胱结石2例,双侧输尿管下段结石1例,一侧输尿管下段结石1例,均采用Turner-Warwick切口,行输尿管切开取石术联合膀胱切开取石术,均行膀胱造瘘术,不放置双＂J＂管,均于输尿管内放置硬膜外导管经膀胱造瘘管引出体外。结果：4例均成功取出结石,7～9d拔除膀胱造瘘管和硬膜外导管,无尿外渗及切口感染,随访无复发。结论：对8岁以下小儿不适合行输尿管镜碎石及ESWL的输尿管下段结石合并膀胱结石的患者,本术式是不错的选择。

The experience to treat bladder calculi and ureteral calculi with TurnerWarwick incision in children

Objective： To evaluate the open surgery method of treating pediatric lower ureteral calculi and bladder calculi with Turner-Warwick incision. Methods： Between 2006 to 2010 years, 4 cases of lower ureteral calculi and bladder calculi pediatric patients consists of 1 girl and 3 boys whose age ranged from 4 to 8 years, mean age 5.8 years underwent open surgery, included 2 cases of lower ureterolithotomy combining cystolithotomy, 1 case of two side of lower ureterolithotomy, 1 case of lower ureterolithotomy. The stones were located on two side lower ureter in 1 case, the one side ureter in 1 case. All of the surgery collected Turner-Warwick incision, and underwent cystostomy, and didn′t detained D-J tube, and detained epidural catheter in ureter through bladder to outside the body. Results： Stones were successfully removed in 4 cases, 7-9 days removal of bladder fistula and epidural catheter, no urinary leakage and wound infection, follow-up without recurrence. Conclusion： Children under the age of 8, is not suitable for ureteroscopic lithotripsy and ESWL for lower ureteral stones combining bladder stones, the open surgery of Turner-Warwick incision is a good choice.