大力碎石钳外鞘组合输尿管镜碎石术治疗直径〉3 cm膀胱结石  

Vigorous lithotripsy outer sheath combined with ureteroscopy lithotripsy for bladder stones larger than 3 cm

作　　者：魏世平 陶维雄 彭伟 李晓山 Wei Shiping;Tao Weixiong;Peng Wei;Li Xiaoshan(Department of Urology,the General Hospital of Yangtze River Shipping,Wuhan 430010,China)

机构地区：[1]长江航运总医院泌尿外科,武汉430010

出　　处：《国际泌尿系统杂志》2021年第4期640-643,共4页International Journal of Urology and Nephrology

基　　金：武汉市卫计委科研课题青年基金项目(WX17Q40)。

摘　　要：目的探讨大力碎石钳外鞘组合输尿管镜碎石术治疗直径>3 cm膀胱结石的效果。方法回顾性分析2013年1月至2019年12月本院收治的108例膀胱结石患者的手术资料,分为实验组(采用大力碎石钳外鞘组合输尿管镜碎石术)和对照组(采用开放膀胱切开取石术),各54例。分析两组间一次取石成功率、手术时间、术中出血量、住院时间、尿管留置时间、围手术期并发症等参数。结果两组一次取石成功率100%,实验组的手术时间、术中出血量、住院时间、尿管留置时间均短于对照组,差异有统计学意义(P<0.05);对照组有3例患者因为切口感染住院时间明显延长,其中1例患者术后合并肺栓塞。结论大力碎石钳外鞘组合输尿管镜碎石术治疗直径>3 cm膀胱结石患者安全有效,尤其适合于膀胱多发结石、高龄、高危、基础疾病多的患者,但不适合开放或其他碎石方式的患者,值得临床推广应用。Objective To investigate the effect of combined ureteroscopy lithotripsy with vigorous lithotripsy outer sheath in treating bladder stones larger than 3 cm.Methods A retrospective a-nalysis of a total of 108 patients with bladder stones from January 2013 to December 2019 were divided into the experimental group(powerful lithotripsy outer sheath and ureteroscopy group)and the control group(open bladder incision and stone removal group),54 cases in each group.Differences in parameters such as the success rate of single stone removal,operation time,bleeding volume,length of hospital stay,urinary drainage time,and perioperative complications were compared and analyzed between the two groups.Results The success rate of one-time stone extraction in the experimental group was 100%.The operation time,intraoperative blood loss,length of hospital stay,and urinary drainage time were significantly shorter than those in the control group,which was statistically significant(P<0.05).The success rate of one-time stone extraction in the control group was also 100%,but the length of hospital stay,urinary drainage time,and complications were significantly higher than those in the experimental group.Three of 54 patients had significantly longer hospital stay due to incision infection,and 1 of them who had postoperative complications with pulmonary embolism had significantly longer hospital stay.Conclusions Vigorous lithotripsy outer sheath combined with ureteroscopy pneumatic ballistic or holmium laser lithotripsy is safe and effective for bladder stones>3 cm in diameter,especially suitable for patients with multiple bladder stones,elderly and high-risk basic diseases,and patients who are not suitable for open or other lithotripsy,it is worthy of clinical application.

关 键 词：膀胱结石 输尿管镜检查 碎石术 碎石钳 

分 类 号：R699[医药卫生—泌尿科学]