不同入路气压弹道碎石术治疗膀胱结石

Clinical study on treating bladder calculi by lithotripsy from different approach

目的探讨不同入路气压弹道碎石术治疗膀胱结石的方法及疗效。方法采用气压弹道碎石术经尿道输尿管镜、经耻骨上膀胱造瘘、经尿道普通膀胱镜、经膀胱镜鞘输尿管镜等4种入路共治疗膀胱结石28例。结果手术一次性成功率89.3%。1例结石残留,1例结石无法固定改开放手术,1例结石核心为异物改开放性手术。手术时间15～60min。结论气压弹道碎石术安全可靠,损伤轻微。以经膀胱镜鞘输尿管镜入路最佳,其次为经尿道普通膀胱镜入路,经尿道输尿管入路适用于尿道狭窄者,经耻骨上膀胱造瘘入路不主张使用。

[Objective] To study the endourological therapeutic method about bladder store by lithotripsy from different approach. [Methods] 28cases of bladder stones were treated with endourological pneumatic lithotriptor by different approaches, including ureteroscope, common cytoscopy, pereutaneous transvesical tube, ureteroscope under common cytoscopy. [Results] Lithotripsy succeeded in 25 cases with 15-60 minutes duration. Fragment stone wasfree in 1 case, alter opening operation in one case because of taking aim at stone difficultly, another case because of core of bladder calculi being eyewinker. [Conclusions] Endourological pneumentic lithotriptor is a safe, cheep, minimally invasive treatment for bladder stone. The approach from ureteroscope under common cytoscopy is the most effective method.