大于10cm膀胱结石1例报告并文献复习

Vesical calculi more than 10 cm in diameter:One case report and literature review

目的:探讨大于10cm膀胱结石的病因、首选辅助检查及治疗方法。方法:回顾性分析1例大于10cm膀胱结石患者的临床资料:因尿频20年余,伴尿痛1周入院。B超检查显示膀胱壁增厚,回声增强,其内见11cm×10cm强光团伴声影;KUB见膀胱区有12cm×10cm团状高密度影。在连续硬膜外麻醉下行膀胱切开取石术。并结合文献复习予以讨论。结果:术后测结石体积为12cm×12cm×11cm,重量为1 025g,呈黄棕色,质地较硬,表面呈分层结构。结石成分分析为草酸钙和尿酸混合型结石。患者术后恢复良好。结论:大于10cm膀胱结石十分罕见。X线检查应作为首选辅助检查方法;治疗宜采用耻骨上膀胱切开取石术。

Objective： To study the etiology, preferred auxiliary examination and treatment of vesical calculi more than 10 cm in diameter. Method： The clinical data of one patient with vesical calculus more than 10cm in diam- eter was analyzed retrospectively. And associated literatures were reviewed. A 42-year-old man was admitted to the hospital with a 20-year history of urinary frequency and a 1-week history of urodynia. B-ultrasonography dem- onstrated a thickened bladder wall and strong echo with acoustic shadow （estimated initially to be approximately 11 cm× 10 cm）. Plain radiography showed a radio-opaque shadow in the pelvis, 12 crux 10 cm in size. Suprapubic cystolithotomy was performed under the continuous epidUral block. Result：The extirpated stone weighed 1 025 g, and measured 12 cm× 12 crux 11 cm in size. The stone was firm and brown-yellow in color, and had several compartments of stratified lamellae composed of calcium oxalate and uric acid. The postoperative recovery was une- ventful. Conclusion：The vesical culeulus more than 10 cm in diameter is extremely rare. Plain radiography should be the preferred auxiliary examination. Suprapubic cystolithotomy is an effective treatment of this disease.