改良膀胱镜鞘加输尿管镜碎石术治疗膀胱结石的临床观察

目的探讨改良F18-F20膀胱镜鞘加输尿管镜气压弹道(或钬激光)碎石治疗膀胱结石的疗效。方法经改良的F18-F20膀胱镜鞘置入输尿管镜,采用气压弹道(或钬激光)将结石击碎,直视下用取石钳通过改良的膀胱镜鞘取出较大的结石碎块,再采用Ellick冲洗器将碎石吸尽。结果 33例膀胱结石,直径0.8～2.5 cm,平均1.3枚。一次性碎石成功率100%,手术时间15～60 min,平均30 min。无尿道损伤,无膀胱出血、穿孔、破裂,术后无膀胱、尿道感染。结论经改良膀胱镜鞘加输尿管镜气压弹道碎石治疗≤2.5 cm的膀胱结石具有微创、安全、手术时间短、并发症少等优点。

Clinical observation on modified cystoscope sheath ureteroscopic lithotripsy for bladder stones

Objective To investigate the effect of ureteroscopic pneumatic(or holmium laser) lithotripsy using modified F18-F20 cystoscope sheath for the bladder stones.Methods Ureteroscope was put through modified F18-F20 cystoscope sheath into the bladder,then pneumatic(or holmium laser) were used to crush stones,under direct vision large stone fragments were clamped out by a stone forceps through the modified cystoscope sheath,and the remained stone fragments were washed out by a Ellick.Results Stone diameter of 33 patients was ranged from 0.8 to 2.5cm,and average stone number was 1.3 per patient.The stone clearance rate in one time was 100%,and the average operation time was 30 min(15-60 min),with no urethral injury,bladder bleeding,perforation,rupture,postoperative bladder,or urinary tract infection occurred.Conclusion The modified cystoscope sheath ureteroscopic pneumatic lithotripsy for bladder stones of ≤2.5 cm is minimally invasive,safe,with shorter operative time and fewer complications.