耻骨上小切口膀胱切开取石术与经尿道钬激光碎石取石术治疗大膀胱结石的临床疗效比较  

Comparison of the Clinical Effects of Small Suprapubic Incision Cystolithotomy and Transurethral Holmium Laser Lithotripsy in the Treatment of Large Bladder Stones

作　　者：周克斌 林佳伟 赵留存 ZHOU Ke-bin;LIN Jia-wei;ZHAO Liu-cun(Department of Urology,Xi'an Ninth Hospital,Xi'an Shaanxi 710054)

机构地区：[1]西安市第九医院泌尿外科,陕西西安710054

出　　处：《医学临床研究》2022年第8期1232-1234,1238,共4页Journal of Clinical Research

摘　　要：【目的】比较耻骨上小切口膀胱切开取石术与经尿道钬激光碎石取石术治疗大膀胱结石的临床疗效。【方法】回顾性分析2018年10月至2020年10月本院收治的94例大膀胱结石的男性患者,根据治疗方法的不同将其分为观察组(行耻骨上小切口膀胱切开取石术)和对照组(行经尿道钬激光碎石取石术治疗)。对比两组手术情况、手术前后视觉模拟评分(VAS评分)、疼痛分级评分法(VRS评分)、最大尿流率、残余尿量及术后并发症发生率。【结果】观察组取石时间、手术时间均短于对照组,差异有统计学意义(P<0.05);两组患者术中出血量、住院时间比较,差异无统计学意义(P>0.05)。两组患者术后VAS评分、VRS评分低于术前,且观察组术后低于对照组,差异有统计学意义(P<0.05)。两组术后最大尿流率高于术前,残余尿量低于术前,且观察组与对照组比较,差异有统计学意义(P<0.05)。观察组术后结石残留、低体温发生率均低于对照组,差异有统计学意义(P<0.05)。【结论】耻骨上小切口膀胱切开取石术相比于经尿道钬激光碎石取石术治疗大膀胱结石更具优势,其手术时间短,可有效减轻患者痛苦,降低并发症发生率,值得推广。【Objective】To compare the clinical effects of small suprapubic incision cystolithotomy and transurethral holmium laser lithotripsy in the treatment of large bladder stones.【Methods】A total of 94 male patients with large bladder stones admitted to our hospital from October 2018 to October 2020 were retrospectively analyzed.According to different treatment methods,they were divided into observation group(small suprapubic incision cystolithotomy)and control group(transurethral holmium laser lithotripsy).The operation condition,VAS score,VRS score,maximum urine flow rate,residual urine volume and postoperative complication rate were compared between the two groups.【Results】The lithotripsy time and operation time in the observation group were shorter than those in the control group(P<0.05);There was no significant difference between the two groups(P>0.05).The VAS score and VRS score of the two groups were lower than that before operation,and that of the observation group was lower than that of the control group(P<0.05).The maximum postoperative urine flow rate of the two groups was higher than that before operation,and the residual urine volume was lower than that before operation.The difference between the observation group and the control group was statistically significant(P<0.05).The incidence of postoperative stone residue and hypothermia in the observation group was lower than that in the control group(P<0.05).【Conclusion】Compared with transurethral holmium laser lithotripsy,small suprapubic incision cystolithotomy has more advantages in the treatment of large bladder calculi.The operation time is shorter,the pain of patients can be effectively reduced,and the incidence of complications can be reduced.It is worth popularizing.

关 键 词：膀胱结石/外科学 碎石术 激光 激光 固体 治疗结果 

分 类 号：R694.4[医药卫生—泌尿科学]