膀胱造瘘改良法治疗膀胱大结石

Bladder Stoma and Pneumatic Ballistic Lithotripsy under Improved Ureteroscope to Outer Sheath of Resectoscope with Lithotripsy Clamp in the Treatment of Big Bladder Stone

目的:探讨膀胱造瘘加自制水封(防水帽)经电切镜外鞘输尿管镜气压弹道碎石联合大力碎石钳碎石治疗膀胱大结石(>2.5 cm)的疗效。方法:膀胱造瘘下经尿道置入电切镜外鞘,套上自制水封,输尿管镜经水封沿电切镜外鞘气压弹道碎石联合大力钳碎石治疗膀胱大结石55例,22例合并BPH,其中有18患者同期行经尿道前列腺电切术(TURP)。结果:患者均一次碎石成功,无严重出血、严重尿外渗、尿道假道、膀胱破裂等并发症发生,无一例中转开放手术。术后随访3～12个月,无远期并发症。结论:该方法具有安全可靠、损伤小、手术时间短、并发症少、适应证广的优点。

Objective：To explore the effect of bladder stoma and pneumatic ballistic lithotripsy under ureteroscope to outer sheath of resectoscope with self-made water closure and lithotripsy clamp in the treatment of big bladder stone. Methods：There were 35 patients suffering from big bladder stone with 22 complicating benign prostatic hypertrophy, among which 18 were performed transurethral resection of the prostate at the same period. An outer sheath of the resectoscope was inserted into the bladder by transurethral approach, and a self-made water closure was covered. The lithotripsy was performed with lithotripsy clamp and the outer sheath of resectoscope under ureteroscope covered the self-made water closure. Results：Of all the 35 cases, bladder stones were successfully treated in one operation without complications such as severe bleeding, severe urinary extravasation, urethral false passage and rupture. The patients were followed up for 3 to 13 months. No long term complications occurred. Conclusions：This method has the advantages of safety, reliability, little trauma, short operation time, few complications and wide adaptability.