经尿道肾镜联合电切镜鞘气压弹道超声碎石清石术在膀胱结石的临床应用

目的 探讨经尿道肾镜联合电切镜鞘气压弹道超声碎石清石术治疗膀胱结石的临床疗效和安全性.方法 回顾性分析采用经尿道肾镜联合电切镜气压弹道超声碎石清石术治疗的34例膀胱结石患者的临床资料,所有患者均经尿道置入F20肾镜,结石大于4 cm可行膀胱造瘘,采用瑞士第四代EMS气压弹道碎石清石系统进行碎石,应用电切镜鞘Ellick冲洗器冲出碎石和肾镜下超声探杆清石,术后留置导尿2～3d.结果 34例患者均手术成功,一次性将膀胱结石去除,无一例中转传统开放性手术,碎石时间8 ～ 45 min,术中术后无膀胱穿孔、大出血、尿道狭窄、急性附睾炎、膀胱痉挛等并发症.结论 经尿道肾镜联合电切镜气压弹道超声碎石清石术治疗膀胱结石是目前疗效确切、适应证广且效率较高的一种有效方法,值得临床上推广应用.

Clinical analysis on bladder calculi treated by nephroscopic pneumatic ballistic lithotripsy combined with resectoscope

Objectives To investigate the efficacy and safety of treating bladder calculi with nephroscopic pneumatic ballistic lithotripsy and resectoscope.Methods A retrospective analysis of 34 clinic cases of treating bladder calculi with nephroscopic pneumatic ballistic lithotripsy and resectoscope in our hospital from 2012 to 2015 was performed.The nephroscope of F20 was placed through urethra in all cases,the bladder calculi treated by ultrasonic lithotripsy system of EMS.Results All of the operations for 34 cases were successful,all bladder calculus were removed only once.The operation time was from 8 min to 45 min.There was not any complications such as bladder bleeding,bladder perforation and cystospasm.Conclusions Treatment of bladder calculus with nephroscopic pneumatic ballistic lithotripsy has many advantages such as definite effec,wide range of indication and high efficiency.It is worthy of clinical application.