经尿道肾镜下超声碎石治疗膀胱结石.docVIP

经尿道肾镜下超声碎石治疗膀胱结石【摘要】 目的 评价经尿道肾镜下超声碎石治疗膀胱结石的疗效。方法 回顾性分析本院2005年3月至2009年11月间经尿道肾镜下超声碎石治疗膀胱结石52例的临床资料。结果 膀胱结石均一次碎石取石,成功率100%,手术时间25～65 min。术后留置尿管1～2 d,无膀胱大出血及膀胱穿孔等并发症。结论 经尿道肾镜下超声碎石治疗膀胱结石,通道大,生理盐水冲洗循环好,视野清楚,碎石取石效率高,手术时间短,膀胱损伤小,适合临床推广应用。 【关键词】 膀胱结石; 超声碎石; 肾镜;尿道 Treatment of bladder calculus with transurethral nephroscope ultrasonic lithotripsy WANG Hong-min,MU Hua,WEI Yong-jin,et al. Kunming Municipal Hospital of Trditional Chinese Medicine,Kunming 650011,China 【Abstract】 Objective To evaluate the efficacy of treating bladder calculus with transurethral nephroscope ultrasonic lithotripsy.Methods To analysis 52 clinical cases retrospectively treating bladder calculus with transurethral nephroscope ultrasonic lithotripsy in our hospital from March 2005 to November 2009.Results All the bladder calculuss were taken out only once and the successful rate was 100%. The time of operation was 25-65 minutes. Kept indwelling catheter 1-2 days after operation without the complications such as bladder bleeding and bladder perforation.Conclusion Treatment of bladder calculus with transurethral nephroscope ultrasonic lithotripsy has advantages oflarge channel, good cycle of saline wash, clear vision,high efficiency, short operative time and small bladder injury and is suitable for clinical application. 【Key words】 bladder calculuss ;ultrasonic lithotripsy ;nephroscope treatment;Urethra 2005年3月至2009年11月,本院采用经尿道肾镜下超声碎石治疗膀胱结石52例,疗效满意,现报告如下。 1 资料和方法 本组52例,男49例,女3例,年龄52～86岁,平均68.1岁,膀胱结石呈卵圆形,大小2.0 cm×1.2 cm～2.8 cm×3.5 cm。单发36例,多发16例,合并前列隙增生肥大41例,在这41例中又同时伴有糖尿病、高血压、心脑血管疾病的患者有38例。术前均行B超及腹部X片检查,均提示膀胱结石。所伴随的糖尿病、高血压、心脑血管疾病均请内科会诊,协助诊治,达到手术麻醉所要求的控制指标[1]。麻醉选择:35例选择连续硬膜外麻醉,17例骶管麻醉,2例未行麻醉,采用盐酸哌替啶100 mg肌内注射加2%利多卡因10 ml尿道灌注。手术器械:EMSⅢ代气压弹道联合超声碎石机。该机仅使用超声碎石系统,F20.8肾镜、超声碎石探针,肾镜取石钳。英国Gyrus等离子双极汽化电切内窥镜系统。治疗方法:麻醉成功后,取截石位,常现消毒铺巾,消毒石腊油润滑尿道,经尿道置入F20.8肾镜,自镜鞘内插入超声碎石探针,连接超声碎石系统进行碎石取石。碎石取石完毕后,退出肾镜,若需同时行前列腺等离子双极汽化电切术治疗的,需换用等离子双极汽化电切镜,行前列腺等离子双极汽化电切术。切除前列腺组织后,用Ellick冲洗器,冲吸出前列腺组织碎块。留置F22三腔导尿管,行