应用Turner-Warwick切口治疗小儿膀胱结石及输尿管结石的体会(1)
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[摘要] 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，7～9 d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。
[关键词] Turner-Warwick切口；小儿；膀胱结石；输尿管结石
[中图分类号] R694+.4 [文献标识码]A[文章编号]1674-4721(2011)08(a)-039-02
The experience to treat bladder calculi and ureteral calculi with Turner-Warwick incision in children
TIAN Zhiguo, LIU Jinghui, WANG Xuesong
Department of Urology, Jishou People′s Hospital of Hunan Province, Jishou 416300, China
[Abstract] 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.
[Key words] Turner-Warwick incision; Children；Bladder calculi; Ureteral calculi
小儿输尿管结石合并膀胱结石病例不多，但是处理较棘手，尤其在基层医院由于没有输尿管镜或没有小直径输尿管镜，对于小于8岁以下的小儿因尿道小，膀胱结石及输尿管结石不能采用膀胱镜及输尿管镜手术腔内手术，且ESWL又不宜采用，这时采用开放手术成为唯一选择。2006年1月～2010年6月，本院收治的4例小儿输尿管下段结石合并膀胱结石患儿采用Turner-Warwick切口开放手术治疗，取得良好效果。现报道如下：
1 资料与方法
1.1 一般资料
第1例，男，5岁，输尿管下段结石(大小1 ......
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