应用超声/气压弹道混合动力碎石清石系统治疗膀胱结石

目的 探讨应用超声/气压弹道混合动力碎石清石系统治疗膀胱结石的方法和疗效.方法 2011年3月～2012年5月,采用瑞士EMS(第四代)超声/气压弹道混合动力碎石清石系统治疗膀胱结石28例.膀胱单发结石9例,多发结石19例,结石大小1.2 ～5.0 cm,平均3.5 cm,其中结石直径＞4 cm者5例.结果 膀胱结石均成功击碎并吸出,碎石清石手术时间8 ～ 75 min,平均35 min.其中22例合并膀胱出口梗阻,同期行经尿道前列腺汽化电切术(TURP)或经尿道膀胱颈电切术(TURBn)治疗,1例膀胱内异位节育器并发结石者先行碎石清石术,再用硬性异物钳将节育器向膀胱腔内拽入并经尿道取出.术中、术后无大出血、膀胱穿孔及水中毒等并发症.结论 EMS(第四代)超声/气压弹道碎石清石系统治疗膀胱结石,具有安全、高效的特点,尤其对于膀胱多发或较大结石(≤5 cm),疗效肯定.

Therapeutic Effects of Ultrasonic and Pneumatic Lithotripsy on Bladder Calculi

Objective To evaluate the clinical effects of ultrasonic and pneumatic lithotripsy on bladder calculi.Methods Between March 2011 and May 2012,a retrospective analysis was performed on 28 patients with bladder stones who were treated with ultrasonic mechanical hybrid power stone clearing system or in combination with pneumatic lithotripsy,including 9 cases of single stone and 19 cases of multiple stone（size： 1.2-5.0 cm,average： 3.5 cm）.The stones in 5 cases were 4 cm in diameter.Results Bladder stones were crushed successfully in all patients and the clearance rate was 100%.The mean lithotripsy time was 35 min（range,8-75 min）.22 cases which complicated with bladder outlet obstruction were treated with transurethral vaporization resection of prostate（TURP） or transurethral resection of bladder neck（TURBn）.No massive hemorrhage,bladder perforation,water intoxication or other complications occurred during and after the lithotripsy.Conclusion Ultrasonic suction combined with ballistic lithotripsy stone clearing system is safe and efficient for bladder calculi treatment,especially for multiple bladder stones or larger stones（≤ 5 cm）.