经尿道微创治疗膀胱血凝块填塞临床分析  

Analysis of transurethral minimal traumatic operation for bladder blood clot

作　　者：朱明德[1] 董焱鑫[1] 高晓康[1] 杨军昌[1] 曾锐[1] 霍双进 李东[1] 

机构地区：[1]兰州军区乌鲁木齐总医院泌尿外科,乌鲁木齐830000

出　　处：《中华实用诊断与治疗杂志》2016年第4期383-385,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的比较电切镜、EMS肾镜、手术刨削器经尿道治疗膀胱内血凝块的手术效果。方法 46例膀胱内血凝块患者采用经尿道微创清除膀胱内凝血块手术,其中电切镜手术25例为电切镜组,EMS肾镜手术11例为肾镜组,刨削器手术10例为刨削器组。观察3组清除血块体积、清除血块时间及血块清除效率。结果电切镜组、肾镜组、刨削器组清除血块体积分别为(258.19±66.37)、(300.57±70.62)、(310.53±81.37)mL,清除血块时间分别为(32.36±10.15)、(24.65±10.07)、(24.22±8.47)min,3组比较差异无统计学意义(P>0.05),肾镜组、刨削器组血块清除效率[(11.43±4.06)、(12.11±4.24)mL/min]高于电切镜组[(7.57±2.25)mL/min](P<0.05),刨削器组与肾镜组比较差异无统计学意义(P>0.05);3组均无中转开腹病例。结论经尿道微创清除膀胱内凝血块安全、可行,应用EMS肾镜和手术刨削器清除膀胱内巨大血凝块效率高。Objective To compare the effects of resectoscopy,EMS nephroscopy and rotating cutter for bladder blood clot.Methods In 46 patients with bladder blood clot underwent transurethral minimal traumatic operation to remove the blood clot,25 patients received resectoscopy（resectoscopy group）,11 received EMS nephroscopy（nephroscopy group）and 10 patients received rotating cutter operation（rotating cutter group）.The volumes of removed blood clot,the operation lasting time and the efficiencies of operation were observed.Results There were no significant differences in the volumes of removed blood clot（（258.19±66.37）,300.57±70.62）,（310.53±81.37）mL）and the operation lasting time（32.36±10.15）,（24.65±10.07）,（24.22±8.47）min）among resectoscopy group,nephroscopy group and rotating cutter group（P〉0.05）.The operation efficiency was（11.43±4.06）mL/min in nephroscopy group and（12.11±4.24）mL/min in rotating cutter group,significantly higher than that in resectoscopy group（（7.57±2.25）mL/min）（P〈0.05）,and there was no significant difference between nephroscopy group and operative rotating cutter group（P〈0.05）.No patient was converted to laparotomy in three groups.Conclusion Transurethral minimal traumatic operation is safe and feasible for bladder blood clot,and EMS nephroscopy and rotating cutter operation are more effective for massive blood clot.

关 键 词：电切镜 EMS肾镜 手术刨削器 经尿道 血凝块 

分 类 号：R699.5[医药卫生—泌尿科学]