耻骨上小切口膀胱切开取石与经尿道钬激光碎石取石治疗大膀胱结石的疗效比较  

Comparison of curative effect of suprapubic incision of bladder lithotomy and transurethral holmium laser lithotripsy in the treatment of large bladder stones

作　　者：黄华松[1] 

机构地区：[1]西昌市人民医院外一科(泌尿外科),四川615000

出　　处：《国际泌尿系统杂志》2016年第4期554-557,共4页International Journal of Urology and Nephrology

摘　　要：目的观察对比耻骨上小切口膀胱切开取石与经尿道钬激光碎石取石治疗大膀胱结石的临床效果。方法选取2010年7月至2015年2月于本院诊治的合并良性前列腺增生的大膀胱结石患者共87例进行研究，随机原则分为研究组（n=45例）和对照组（n=42例），对照组实施经尿道钬激光碎石取石，研究组行耻骨上小切口膀胱切开取石治疗，均同期行TURP。比较两组术中出血量、总手术时间、取石时间、低体温、输血例数、住院时间、术后疼痛情况、治疗费用、术后并发症。结果两组的出血量、住院时间、尿道狭窄发生率相比较无明显差异（P〉0．05）；两组碎石取石时间、总手术时间对比，研究组均短于对照组（P〈0．05）；研究组术中低体温发生率、治疗费用、术后泌尿系感染、结石残留发生率均较对照组更低（P〈0．05）。结论对临床中大膀胱结石患者采取耻骨上小切口膀胱切开取石治疗，手术时间短，结石残留率低，术后并发症少，效果显著，值得推广。Objectives To observe and compare the clinical effect of suprapubic incision of bladder lithotomy and transurethral holmium laser lithotripsy in the treatment of large bladder stones. Methods 87 cases of patients with large bladder stones and benign prostatic hyperplasia in our hospital from July 2012 to February 2015 were chosen. And all patients were randomly divided into the study group group（45 cases）and the control group（42 cases）. The control group were treated with transurethral holmium laser lithotripsy, while the study group given suprapubic incision of bladder lithotomy treatment,and all patients were treated with TURP at the same time. To compare the blood loss, total operation time, stone time, low body temperature, blood transfusion cases, hospitalization time, postop- erative pain, treatment costs and postoperative complications in two group. Results There was no significant difference between the two groups in the amount of bleeding, hospitalization time and urethral stricture （ P 〉 0.05） ; the stone removal time and total operation time of the study group was slightly shorter than that of the control group（ P 〈 0.05 ） ;In the study group, the incidence of hypothermia, treatment costs, postoperative urinary tract infection, the incidence of residual stones were lower than the control group（ P 〈 0.05）. Conclusions Suprapubic incision of bladder lithotomy is used in treating the patients with large bladder stones, the operation time is short, the stone residue rate is low, the postoperative complications are few, the effect is remarkable, it is worth promoting.

关 键 词：膀胱结石 碎石术 激光 激光 固体 尿道 耻骨 

分 类 号：R699.5[医药卫生—泌尿科学]