加压冲洗系统在膀胱结石碎石术中的应用研究

目的 评价气压弹道碎石加压冲洗系统在电切镜外鞘辅助输尿管镜气压弹道碎石取石术处理膀 胱结石的应用价值。方法 分析陕西省宝鸡市中心医院3 年内接受气压弹道碎石术的膀胱结石患者的临床 资料，123 例患者随机分为两组：A 组62 例，采用加压冲洗系统电切镜外鞘辅助输尿管镜气压弹道碎石取石 术；B 组61 例，采用艾力克吸引球辅助电切环结合输尿管镜气压弹道碎石取石术。术后均常规留置三腔导 尿管。比较两组的手术时间、结石清除率及术后并发症等情况。结果 全部患者成功碎石取石，两组的碎石 时间比较有差异（P <0.05）；术后随访3 ～ 12 个月，两组泌尿系超声及腹平片复查均未见结石残留及复发。 结论 术中应用气压弹道碎石加压冲洗系统可以缩短电切镜外鞘辅助输尿管镜气压弹道碎石术清石时间，该 方法处理膀胱结石安全有效，值得推广应用。

Application of pressurized flushing system in transurethral lithotripsy of bladder calculi

Objective To evaluate the clinical value of pneumatic lithotripsy pressurized flushing system in the treatment of bladder stones with ureteroscopic pneumatic lithotripsy via out sheath of resectoscope. Methods The clinical data of 123 patients with bladder stones who underwent ureteroscopic pneumatic lithotripsy in our hospital in the past 3 years were reviewed. The patients were randomly divided into two groups. The 62 patients in the group A were performed with ureteroscopic pneumatic lithotripsy via out sheath of resectoscope assisted by pressurized flushing system, while the 61 patients in the group B received ureteroscopic pneumatic lithotripsy assisted by Elick suction ball. Three-cavity catheter was routinely indwelt after operation. Operation time, stone clearance rate and postoperative complications were compared between the two groups. Results The lithotripsy was successfully accomplished in all patients and none of the cases was converted to open surgery. The stone clearance time was (24.6 ± 5.1) and (31.2 ± 7.2) min respectively in the group A and the group B (P < 0.05). During the postoperative followup of 3-12 months, none of the patients had stone residue or recurrence through ultrasonography and KUB plain film examination. Conclusions The application of pneumatic lithotripsy pressurized flushing system can shorten the operation time in the treatment of bladder stones with ureteroscopic pneumatic lithotripsy via out sheath of resectoscope. It is a safe and effective method in the treatment of bladder stones, which deserves clinical application in primary hospitals.