经电切镜外鞘输尿管镜下气压弹道碎石治疗膀胱结石

目的探讨经电切镜外鞘输尿管镜下气压弹道碎石治疗膀胱结石的疗效。方法2002年3月～2005年2月,膀胱结石42例（男39例,女3例）,其中合并前列腺增生20例,膀胱颈纤维化3例,采用经电切镜外鞘置入输尿管镜,气压弹道碎石将膀胱结石击碎,Ellik冲洗器将碎石冲出,20例合并前列腺增生者同时行经尿道前列腺电切术。结果42例均一次性将结石击碎并全部冲出,术中、术后未出现大出血、膀胱穿孔和水中毒等并发症。42例术后随访6～18个月,平均8个月,均未见结石复发,排尿通畅。结论经电切镜外鞘输尿管镜下气压弹道碎石是治疗膀胱结石的有效方法,具有操作简便、高效、并发症少、效果确切等优点,值得临床推广应用。

Pneumatic Ballistic Lithotripsy via the Outer Sheath of Resectoscope in the Treatment of Bladder Calculi

Objective To discuss the technique and therapeutic effect of pneumatic ballistic lithotripsy for the treatment of bladder calculi under ureteroscope via the outer sheath of reseetoscope. Methods Totally 42 patients with bladder calculi （39 men and 3 women）were treated in our hospital form March 2002 to February 2005. Among the patients,20 cases were complicated with BPH,and 3 had bladder fabrosis. The cystolith was crushed with pneumatic ballistic lithotripsy under an ureteroseope via the outer sheath of resectoseope. For the patients complicated with BPH （20 eases） , prostatectomy was performed at the same time. Results All the cases were cured in one session. No massive hemorrhage, bladder perforation, or overhydration occurred after the operation in this series. The patients were followed up for 6 to 18 months （ mean 8 months） , during which no recurrent cases were found, all the patients had normal urination. Conclusions Pneumatic ballistic lithotripsy via the outer sheath of resectoseope is an effective, simple, accurate method for the treatment of bladder stones. The procedure is superior in less complications and good outcomes.