经皮膀胱造瘘输尿管镜下钬激光碎石治疗膀胱结石的疗效观察

Outcomes of Percutaneous Suprapubic Cystolithotripsy Combined with Ureteroscopic Holmium Laser in the Treatment of Bladder Calculi

目的:探讨经皮膀胱造瘘输尿管镜下钬激光碎石治疗膀胱结石的有效性与安全性。方法:大体积或多发膀胱结石患者20例,均采用经皮膀胱造瘘输尿管镜下钬激光碎石。结果:所有手术顺利完成。平均手术时间25min(10-40min),结石取净率100%,术中无膀胱穿孔或破裂、尿道损伤,术后无大出血、尿道狭窄、感染等并发症。随访平均6个月(1-24个月),无结石复发及尿道狭窄。结论:经皮膀胱造瘘输尿管镜下钬激光碎石术治疗膀胱结石效果满意,避免了患者排石痛苦或开放手术的损伤。

Objective： To investigate the efficiency and safety of percutaneous suprapubic cystohthotnpsy combined with ureteroscopic holmium laser in bladder stone cases. Methods： Twenty patients with big volume or mutiple bladder stones were treated by percutaneous suprapubic cystolithotripsy combined with ureteroscopic holmium laser. Results： Lithotripsy was performed successfully in all patients, the stone clearance rate was 100%, and the average operation time was 25 min （10-40 min） without any obvious complications such as bladder perforation, severe blood loss, urethral injury, urethral stenosis, and infection. Neither stone recurrence nor urethral stenosis occurs after a follow-up of 6 months （1-24 months）. Conclusion： Both efficiency and safety of percutaneous suprapubic cystolithotripsy combined with ureteroscopic holmium laser are satisfactory for the patients with big volume or mutiple bladder stones.