经尿道超声联合气压弹道治疗膀胱结石30例临床分析

Combination of transurethrai pneumatic and ultrasonic cystolithotripsy： a clinical analysis of 30 cases

回顾总结前列腺增生合并膀胱结石30例患者的临床资料。结石长径1．5～4．0cm。肓插或直视下经尿道置人电切镜鞘，应用标准肾镜和第三代EMS碎石清石系统击碎结石并吸出，较大或较硬结石联合气压弹道治疗。均成功碎石，碎石时间10～25min，同期行经尿道前列腺电切术（TURP）28例，无膀胱穿孔、电切综合征及严重出肌发生。术后1例出现膀胱颈口挛缩，行内镜下电切治愈。无残石及膀胱结石复发。此方法治疗膀胱结石高效、安全，未增加同期TURP的风险。

The clinical data of 30 patients with vesical calculus of 1.5 cm to 4 cm in diameter, who underwent combination of transurethral pneumatic and ultrasonic cystolithotripsy, were retrospectively analyzed. During the procedure the resectoscopie sheath was inserted into bladder through urethra, then the nephroscope was placed through the sheath. When the stone was located, the ultrasonic and pneumatic devices were used [or lithotripsy and the fl＇agments were cleared out. The procedures lasted from 10 to 25 rain, all operations were successful. Transurethral resection of prostates （TURP） was performed simultaneously in 28 patients. No serious bleeding, bladder injury or transurethral resection syndrome occurred. One patient with simultaneous TURP developed bladder neck contracture one month after surgery and was later cured by endoresection. No residual chip or stone recurrenee was detected. This procedure appears to be safe and highly efficient with low rate of urethrostenosis and is suitable for simotaneous prostate surgery.