肾镜下超声弹道碎石治疗膀胱结石65例疗效分析

Therapeutic Effect of Nephroscopic Ultrasound Lithotripsy on Bladder Calculi: An Analysis of 65 Cases

目的探讨超声弹道碎石在膀胱结石治疗中的临床效果。方法对65例采用超声机械混合动力碎石清石系统或联合气压弹道碎石的膀胱结石患者的临床资料进行回顾性分析。结果 65例患者均碎石成功,碎石清石手术时间为20～90min,平均55min,清石率均为100%。住院时间4～7d。术后复查腹部平片(KUB),膀胱内均无结石残留。碎石过程及术后无大出血、膀胱穿孔和水中毒等并发症。术后留置导尿3d,拔除导尿管后排尿症状较前有明显的改善。术后随访6～12个月,无结石复发及排尿不畅等。结论超声波负压吸引联合其他弹道碎石清石系统治疗膀胱结石,具有创伤小、安全、高效、患者恢复快的优点,前列腺增生症并发膀胱结石患者可联合应用微创方法进行治疗。

ObjectiveTo evaluate the clinical effects of ultrasonic and pneumatic lithotripsy on bladder calculi.MethodsA retrospective analysis was performed in 65 patients with bladder stones who were treated with ultrasonic mechanical hybrid power stone clearing system or in combination with pneumatic lithotripsy.ResultsBladder stones were crushed successfully in all patients and the clearance rate was 100%.The mean lithotripsy time was 55 minutes（range,20-90 minutes） and the hospital stay was 4-7 days.After operation,plain film of kidney,ureter,and bladder（KUB） showed no residual stones.No massive hemorrhage,bladder perforation,water intoxication or other complications occurred during and after the lithotripsy.Indwelling catheter was kept for 3 days after operation and urinary symptoms were significantly improved after catheter removal.No stone recurrence and voiding difficulty occurred during the 6-12 months of follow-up.ConclusionUltrasonic suction combined with other ballistic lithotripsy stone clearing system is safe and efficient for bladder calculi with advantages of little trauma and rapid recovery.Benign prostatic hyperplasia complicated with bladder stones can be treated with nephroscopic ultrasound lithotripsy combined with minimally invasive method.