膀胱结石患者结石定位于膀胱体外侧壁碎石效果观察

目的探索一种能取得最佳体外冲击波碎石效果的膀胱结石定位的解剖部位。方法利用随机数字表将100例膀胱结石患者分为两组,每组50例,单数为观察组,双数为对照组。观察组采用定位于膀胱体外侧壁的侧-俯卧位进行体外冲击波碎石为改进定位组,对照组将结石定位于膀胱顶部的俯卧位进行体外冲击波碎石为常规定位组。观察碎石后两组结石破碎颗粒的大小、全部碎石排净时间及排尿顺畅和碎石嵌顿的情况。结果改进定位组排出的碎石颗粒全部<4mm,常规定位组有14例>4mm,碎石效果明显高于常规定位组(P<0.01)。两组碎石颗粒经t检验,P<0.001,有显著性差异,改进定位组碎石颗粒比常规定位组小。碎石排净时间:改进定位组50例2d内全部排净,常规定位组有10例在3～12d排净,两组碎石排净时间比较有显著性差异(P<0.01)。改进定位组碎石后排尿顺利,无1例出现碎石嵌顿,常规定位组有10例碎石嵌顿。结论膀胱结石患者采用结石定位于膀胱体外侧壁碎石效果优于定位于膀胱顶部。

The effects of extracorporeal shock wave lithotripsy on vesical calculus

Objective To find an anatomical position at which extracorporal shoc k wave lithotripsy can reach a best effect in treating patients with vesical cal culus in lateralis of bladder. Methods 100 cases with vesical calculus were ran domized into two groups in an even way: those with odd number as observational g roup and those with even number as controls. During undergoing extracorporeal sh ock wave lithotripsy, those taking lateral prone position subject to the locatio n at lateral wall of bladder were put in improved position group and those takin g prone position subject to the location at apex of bladder were in routine grou p. After operation of extracorporeal shock wave lithotripsy, the size of broken calculus, the time of ejecting calculus, urination and incarceration of broken c alculus were compared between the groups. Results The size of removed calculus was all less 4 mm in the group taking improved position but more than 4 mm in 14 cases in the group taking routine position. All removed the calculus in 2 days in the group taking improved position and 10 cases removed the calculus in 3~12 in the group taking routine position, with significant difference between the tw o groups (P<0.01). Urination in the improved position group was smooth without i ncarceration but in the latter group incarceration happed in 10 cases. Conclusio n The lateral prone position subject to location at lateral wall of bladder is more effective than the prone position subject to the location at apex of bladde r in removing calculus by extracorporeal shock wave lithotripsy.