三种腔镜手术方法治疗膀胱结石的比较研究

目的:比较电切镜联合输尿管镜下气压弹道碎石术、肾镜下气压弹道碎石术及肾镜下EMS五代超声碎石清石系统手术等三种腔镜手术方法治疗膀胱结石的疗效。方法:回顾性分析我院2011年5月~2014年2月腔镜手术治疗膀胱结石122例患者的临床资料,其中采用电切镜联合输尿管镜下气压弹道碎石术(组1)治疗41例,肾镜下气压弹道碎石术(组2)治疗47例,肾镜下EMS五代超声碎石清石系统手术(组3)治疗34例。比较三组的疗效。结果:122例手术均成功,无严重出血、膀胱穿孔等并发症。组1碎石手术时间为5~63min,平均(29.9±14.1)min;组2碎石手术时间为12~63min,平均(32.1±13.9)min;组3碎石手术时间为5~42min,平均(20.5±8.9)min。组1总住院时间为6~17d,平均(11.4±2.7)d,组2为7~18d,平均(11.6±2.7)d;组3为7~17d,平均(11.6±2.8)d。术后随访1~24个月,无远期并发症。结论:三种腔镜手术治疗膀胱结石均安全、有效。肾镜下EMS五代碎石清石系统手术有碎石效率高、手术时间短等优点。

Comparative study of three endoscopic operations in treating bladder calculus

Objective：To compare the efficacy of three endoscopic operations,pneumatic ballistic lithotripsy with resectoscope and ureteroscope,pneumatic ballistic lithotripsy with nephroscope,pneumatic combined with ultrasonic lithotripsy with nephroscope（the fifth generation EMS）.Method：A total of 122 patients with bladder calculus underwent operations in our hospital from May 2011 to February 2014,including 41 cases of pneumatic ballistic lithotripsy with resectoscope and ureteroscope（Group One）,47 cases of pneumatic ballistic lithotripsy with nephroscope（Group Two）,34 cases of pneumatic combined with ultrasonic lithotripsy with nephroscope（Group Three）.We compared the surgical treatment effect.Result：All 122 surgeries were successful without severe complications such as bleeding,bladder perforation.The operation time for stone extraction was 5-63（mean,29.9±14.1）min for Group One,12-63（mean,32.1±13.9）min for Group Two and 5-42（mean,20.5±8.9）min for Group Three.The hospital stay was 6-17（mean,11.4±2.7）d for Group One,7-18（mean,11.6±2.7）d for Group Two and 7-17（mean,11.6±2.8）d for Group Three.The patients were followed up for 1-24 months.No long-term complications occurred.Conclusion：Three endoscopic operations are safe and effective for the treatment of bladder calculus.Pneumatic combined with ultrasonic lithotripsy with nephroscope has the advantages of shorter operation time and higher efficiency.