尿道结石梗阻急诊腔内碎石治疗(附25例报告)

The emergency treatment by intracavitary therapy for urethral calculus Obstruction

目的探讨尿道结石梗阻急诊腔内治疗的手术疗效。方法采用气压弹道联合超声及钬激光碎石急诊治疗尿道结石梗阻25例,均为男性,平均年龄20.1岁。后尿道结石11例,前尿道结石14例,结石直径平均1.2 cm。结果 8例患者采用气压弹道联合超声吸附碎石系统碎石,17例采用钬激光碎石,手术平均时间45 min,结石清除率100%。25例均无尿道假道形成及膀胱穿孔等并发症,术中几乎无出血,术后患者排尿通畅,16例随访3～38个月,无尿道狭窄。结论腔内碎石技术治疗尿道结石具有损伤小、成功率高、并发症少、恢复快的优点。处理尿道结石及减少并发症是决定治疗方法的主要因素。

Objective To evaluate the therapeutic effects of emergency treatment by intracavitary therapy for urethral calculus Obstruction.Methods Retrospective analysis clinical data of 25 cases about urethral calculus Obstruction treated by holmium laser lithotripsy and ballistic lithotripsy.All patients were male,the average age was 20.1 years old,including posterior urethral calculus 11 and anterior urethral calculus 14.The average diameter was 1.2 cm,creatinine were abnormal for 3 cases,all patients were given emergency operation.Results Eight patients were used ballistic lithotripsy under ureteroscope;17 cases were treated by holmium laser.An average time was 45 minutes,clearance rate was 100%.No urethra false passage and vesical perforation,non-haemorrhage almost in operation.With 3～38 months following up in 16 cases,without urethrostenosis.Those patients of Creatinine abnormality left hospital 3 days later when creatinine was normal.Conclusion Intracavitary therapy for urethral calculus is safety and efficient method with less complications,little trauma and rapid recovery.To deal with urethral calculus,the position is not determinative factor.How to avoid injury of urethra and reduce complications are main factor to determine the treatment.By the development of endoscopic technique in urinary surgery.The treatment of urethral calculus will gradually achieve to endoscopic treatment.