【2019EAU中国好声音】中国学者儿童肾结石研究成果获国际同行关注

北京大学国际医院贾建业、张弋等教授和医生在治疗儿童结石病领域积累丰富临床经验，该团队的相关研究“Treatment of Renal Calculiin Children with Extracorporeal Shockwave Lithotripsy”在大会上得到与会泌尿专家和同道的关注，儿童体外碎石相关内容也进行深入的讨论与交流。

EAU等重要国际泌尿组织不仅是专业探讨和交流的平台，对技能培训和青年医生培养同样非常重视。

贾建业教授在会议上和全球泌尿顶级学术组织（Endourology Society）的John Denstedt教授交流了近几年北京大学国际医院开展的中国青年医师体外冲击波碎石规范化教育，以及培训流程的探索与改进。

培训内容不限制医生的思路，利用各种手段促进实操训练，放开学员手脚，并通过不断发现与创新为儿童结石病ESWL治疗提供循证医学的新证据。

2018.5.3-4Endourology Society Global Education Initiative course在中国北京友谊医院成功举办，当时Prof. Denstedt 和Prof. Joyce两位教授对贾教授所作的工作就有全面了解，并结下了深厚友情。Denstedt接受对该项工作给予了积极评价，称之为“Very good method”。

EAU会议讨论中，认为儿童身体特点和结石特性对ESWL适应症、禁忌症、操作技巧等提出不同于成人的要求。

贾建业和张弋两位教授了解到，目前我国ESWL治疗儿童结石治疗例数最多、复杂程度高，特别是对儿童体外冲击波碎石麻醉，围手术管理等具有很高水平，为推动这项工作起到积极作用。

北京大学国际医院泌尿外科儿童结石病治疗经历4年的积累与创新，团队协作、培训能力、学术水平及影响力稳步上升，在国内乃至国际结石亚专业交流重要平台上逐渐发挥影响，已形成一支强有力的结石治疗团队，在合作共赢的推动下，前进的步伐将更稳、更快。

附贾建业、张弋团队的“Treatment of Renal Calculiin Children with Extracorporeal Shockwave Lithotripsy”研究成果摘要?

【 Abstract 】

Objectives： To evaluate the safety and efficacy of extracorporeal shock wave lithotripsy for treating renal partial staghorn calculi in children and to present our experience.

Patients and Methods: From March 2009 to September 2013, 53 children (age 7 months to 12 years) underwent ESWL for treatment of renal partial staghorn calculi using a Dornier Compact Delta II lithotripter. Technical parameters were selected and recorded based on the age of the children. The number of shock waves and energy level used were 1000-3500 and 2.5-45 mJ, respectively. No more than three ESWL treatments were used. The interval between sessions was no less than three weeks. Treatment was considered successful if a patient was free of stones on B ultrasound and CT scan after a 3-month interval. Patient, stone, and kidney characteristics were evaluated as predictors of ESWL success using univariate and multivariate analyses.

Results: Overall, 45 of 53 patients (84.9%) became stone-free after the ESWL treatment. In four cases (7.55%), the stones failed to break after 3 sessions; they were then managed using PCNL. Four other children (7.55%) had residual stones. The statistical analyses revealed that only the CT value had a statistically significant effect on ESWL success. The ESWL success rate was 94.1% in patients with a stone of <800 HU and 68.4% for ≥800 HU (p=0.035). Eventually, we summarized the technical parameters for paediatric renal partial staghorn calculi based on the age of the child being treated.

Conclusion: Monotherapy ESWL is a safe and effective method for treating paediatric renal partial staghorn calculi. We recommend that it be the first-option therapy for calculi of <800 HU. We believe that the technical parameters of ESWL in this study are valuable recommendations for paediatric patients, especially infants, but not for adults.