低压CO_2气膀胱下膀胱结石碎石钳碎石术的可行性  

Feasibility of lithoclast lithotripsy under low pressure CO_2 gas bladder

作　　者：李楠 乔西民 徐晓峰 郭亚收 肖湘 程海峰 凡振伟 杜泉 张少杰 

机构地区：[1]咸阳市中心医院泌尿外科,陕西咸阳712000

出　　处：《现代泌尿外科杂志》2016年第11期867-869,共3页Journal of Modern Urology

摘　　要：目的研究在低压CO2气膀胱的条件下行经尿道膀胱结石大力碎石钳碎石术治疗的安全性及高效性。方法将2012年3月至2015年3月我科收治的75例膀胱结石患者随机分组，分别采用传统膀胱灌注液体（37例）和低压CO2气膀胱条件下（38例）行经尿道碎石钳碎石术治疗，比较分析两组病例的膀胱黏膜损伤例数、膀胱壁损伤例数、导尿管留置时间等安全性指标及碎石时间、结石残留情况（是或否）等有效性指标。结果经尿道低压CO2气膀胱下膀胱结石碎石术组患者38例，碎石时间（7.57±5.57）min，膀胱黏膜出血1例，膀胱壁损伤0例，中转开放手术0例，术后留置尿管时间平均（6.57±2.87）d，术后结石残留1例，残留结石直径1 mm（沙粒样）。经尿道膀胱灌注生理盐水条件下膀胱结石碎石术组患者37例，平均碎石时间（27.62±16.71）min，膀胱黏膜出血17例，膀胱壁损伤5例，膀胱壁穿孔中转开放手术修补1例，术后留置尿管时间平均（8.16±3.12）d，术后结石残留5例，残留结石直径3~5 mm。两组病例有效性及安全性指标数据比较，差异有显著性统计学意义（P＜0.05）。结论与传统膀胱灌注生理盐水相比，低压CO2气膀胱法下经尿道大力碎石钳碎石术视野清晰，可有效减少碎石钳对膀胱黏膜的副损伤，安全性更高，碎石效率显著提高。ObjectiveTo explore the safety and efficiency of lithoclast lithotripsy in the treatment bladder calculi under CO2 gas bladder. MethodsA total of 75 patients with bladder calculi treated during March, 2013 and March, 2015 were enrolled. The patients were divided into 2 groups： traditional bladder irrigation group （n=37, traditional group）, and lithotrite group （n=38, lithotrite group）. The number of patients whose bladder mucosa and bladder wall were damaged were recorded. Periorperative data including time of catheterization, time to break stones, residual calculi were assessed.ResultsIn the lithotrite group, the average stone-breaking time was （7.57±5.57） min. Mucosa hemorrhage occurred in 1 case. No patients had bladder wall damage or converted to open surgery. The average time of postoperative catheter indwelling was （6.57±2.87） d. Residual stones were observed in 1 case, the diameter of which was 1mm （sand-like）. In the traditional group, the average stone-breaking time was （27.62±16.71 ）min. Mucosa hemorrhage occurred in 17 patients. Bladder wall damage occurred in 5 cases, and 1 patient who had bladder wall perforation converted to open surgery. The average time of postoperative catheter indwelling was（8.16±3.12） d. Residual stones were observed in 5 cases, the diameter of which was 3-5 mm （granular-like）.There were significant differences between the two groups （P〈0.05）. Conclusions Compared with traditional irrigation, lithoclast lithotripsy under CO2 gas bladder can acquire clear vision and reduce the damage to the bladder mucosa. It is a safe and effective method.

关 键 词：膀胱结石 膀胱低压 CO2气膀胱 碎石钳 碎石术 

分 类 号：R69[医药卫生—泌尿科学]