【摘要】 目的 探讨肾镜结合气压弹道碎石治疗膀胱结石的临床疗效。 方法 分析2004年9月－2011年3月男性膀胱结石患者87例的临床资料。结石直径1.5~6.7 cm，使用肾镜结合气压弹道碎石术治疗，统计手术时间、手术并发症。随访3个月，观察有无尿道狭窄。 结果 所有患者碎石成功，平均手术时间为37 min，无残留结石，无膀胱穿孔、感染性休克、膀胱大出血等并发症；术后3个月随访，经尿道手术者均未发现尿道狭窄。 结论 肾镜下气压弹道碎石术是治疗膀胱结石安全、有效的方法。【Abstract】 Objective To explore the clinical efficacy of pneumatic ballistic lithotripsy via nephroscope in treating patients with bladder stones. Methods We retrospectively analyzed the clinical data of 87 patients with bladder stones from September 2004 to March 2011. The diameter of the stones were ranged from 1.5 to 6.7 cm. The patients underwent peneumatic ballistic lithotripsy via nephroscope. We recorded the operation time and complications, and observed the incidence of urethrostenosis 3 months after the beginning of the follow-up. Results All stones were fragmented and removed successfully. The average operation time was 37 minutes. No residual stone, bladder perforation, infective shock or severe bleeding of the bladder occurred. During the 3-month follow-up, no utethrostenosis occurred. Conclusion Pneumatic ballistic lithotripsy via nephroscope is a safe and efficient technique in treating bladder stones.
【摘要】 目的 探讨良性前列腺增生（benign prostatic hyperplasia，BPH）伴膀胱结石的有效腔内治疗方法。〖HTH〗方法 2003年6月-2009年12月，使用F26号电切镜外鞘作为撑开器，气压弹道和（或）钬激光粉碎膀胱结石，经尿道前列腺电切术 （transurethral resection of the prostate，TURP） 治疗BPH伴膀胱结石86例。患者年龄58～83岁，平均68.6岁；病程2～8年，平均5.2年。术前患者国际前列腺症状评分（international prostate symptom score，IPSS）为（24.6±3.9）分，生活质量（5.7±0.6）分；前列腺重量（46.5±6.8） g，剩余尿量（185±58） mL，最大尿流率（5.7±2.3） mL/s。 结果 86例均一次手术成功。碎石时间为16~58 min，平均38 min；前列腺电切时间40~100 min，平均65 min。术中无并发症发生。术后 5~8 d拔除尿管，平均6.5 d。术后4 例出现前尿道狭窄，经治疗后痊愈。54例获随访，随访时间2~6个月，平均3个月。术后2个月，54例最大尿流率升至（18.5±4.1） mL/s，剩余尿量下降至（16±22） mL，IPSS评分下降至（7.8±1.6）分，生活质量（2.5±0.3）分，与术前比较差异均有统计学意义（Plt;0.01）。 结论 经尿道碎石术和TURP一次性治疗BPH伴膀胱结石安全、有效、经济。【Abstract】 Objective To explore an effective endourologic treatment method for benign prostatic hyperplasia (BPH) with bladder calculi. Methods From June 2003 to December 2009, ballistic or holmium laser lithotripsy by outer sheath resectoscope and transurethral resection of the prostate (TURP) were performed on 86 patients with BPH and bladder calculi. The patients aged 58 to 83 years old, averaging at 68.6 years. Duration of their disease course ranged from 2 to 8 years, averaging 5.2 years. Before surgery, the international prostate symptom score (IPSS) was 24.6±3.9; the score of quality of life (QOL) was 5.7±0.6; prostatic weight was (46.5±6.8) g; residual urine (RU) volume was (185±58) mL; and the peak urine flow rate (Qmax) was (5.7±2.3) mL/s. Results The operations were completed successfully in all cases with a mean lithotripsy time of 38 min (16-58 minutes) and a mean TURP time of 65 min (40-100 minutes). No complications occurred during the operation. Urethral catheter was withdrawn 5-8 days after operation, with a mean period of 6.5 days. Four patients had anterior urethral stricture after operation, but recovered through treatment. Fifty-four patients were followed up for 2 to 6 months with an average follow-up time of 3 months. Two months after the operations, IPSS decreased to 7.8±1.6; Qmax increased to (18.5±4.1) mL/s; RU decreased to (16±22) mL and QOL was 2.5±0.3. Compared with preoperative conditions, the differences were all statistically significant (P＜0. 01). Conclusion Transurethral lithotripsy combined with TURP is an effective, safe and economical treatment for benign prostatic hyperplasia with bladder calculi.
目的:探讨微创治疗BPH并发膀胱结石的方法。方法:应用气压弹道碎石术联合TURP治疗BPH并发膀胱结石26例。结果:24例一次成功,1例一期碎石,二期行TURP;1例中转开放手术。结论:气压弹道碎石术联合TURP治疗BPH并发膀胱结石创伤小,恢复快,安全高效。
目的:探讨基层医院前列腺增生并膀胱结石的微创治疗方法。方法:联合经尿道等离子双极电切与耻骨上小切口治41例前列腺增生症并膀胱结石。结果:手术时间40~110min, 平均55min,术后3d拔造瘘管, 第5~6天拔除尿管,排尿通畅, 无电切综合征(TURS)、大出血等并发症,住院时间7±1.5天。数字疼痛评分0~6,平均3.5。结论：等离子体双极电切结合耻骨上小切口是治疗前列腺增生并膀胱结石的一种快速、安全有效、微创的手术方法,值得在基层医院推广。