构建三通道碎石系统处理合并前列腺增生的复杂性膀胱结石

Construction of a three-channel stone clearance system for the treatment of complicated bladder stones in patients with benign prostatic hyperplasia

目的 探讨一种新型碎石模式的构建及处理合并前列腺增生的复杂性膀胱结石的临床效果.方法 以电切镜鞘、肾镜镜鞘、膀胱侧视镜构建出三通道碎石系统,结合气压弹道碎石治疗42例合并前列腺增生的复杂性膀胱结石,比较碎石效果及术前、术后3个月I-PSS、QOL评分、BOO分级、Qmax差异.结果 42例患者均一次清石成功,碎石时间（43.6±11.2） min;无膀胱穿孔、明显水外渗、大出血、严重尿道损伤等并发症;顺利进行进一步经尿道前列腺电切术.术后3月I-PSS评分（9.5±3.6）分,QOL评分（1.3±1.2）分,Qmax（17.7±5.9） mL,以及BOO分级与术前比较差异均有统计学意义.结论 电切镜鞘、肾镜镜鞘及膀胱侧视镜构建出的三通道碎石系统可以连续高效地处理合并前列腺增生的复杂性膀胱结石,临床效果良好.

Objective To explore the construction of a new stone clearance model and evaluate its clinic effect in the treatment of complicated bladder stones in patients with benign prostatic hyperplasia.Methods Forty-two cases of complicated bladder stones in patients with benign prostatic hyperplasia were treated by pneumatic lithotripsy using a three-channel stone clearance system composed of a resectoscope sheath,nephroscope sheath and lateral bladder telescope.Comparisons of gravel effect and I-PSS score,QOL score,BOO grade and Qmax differences preoperatively and 3 months post-operatively were made.Results Forty-two cases were stone-free with the first treatment without complications （bladder perforation,obvious water extravasation,serious bleeding or urethral injury）,and the average time for lithotripsy was （43.6 ± 11.2） minutes.Subsequent transurethral resection of the prostate surgery was performed successfully.When measured at 3 months post-operatively,I-PSS score（9.5 ± 3.6） points,QOL score（1.3 ± 1.2） points,Qmax（17.7 ± 5.9） mL and BOO classification were significantly different when compared to preoperative scores.Conclusion The three-channel stone clearance system consisting of resectoscope sheath,nephroscope sheath and lateral bladder telescope can continuously and efficiently handle complicated bladder stones in patients with benign prostatic hyperplasia,leading to good clinical results.