透明软管在前列腺增生合并膀胱结石碎石改良治疗膀胱结石的应用研究

Clinical research on application of transparent hose in benign prostatic hyperplasia complicated with bladder stone lithotripsy modified treatment of bladder stone

目的探讨应用透明软管治疗前列腺增生合并膀胱结石在经尿道微创碎石中的疗效。方法 2010年2月-2015年2月良性前列腺增生症（BPH）合并膀胱结石患者选取了膀胱结石〉2 cm病例,按膀胱结石碎石取石方式不同分为两组。观察组前列腺增生合并膀胱结石的患者86例,应用透明软管治疗膀胱结石,对照组患者48例,应用前列腺电切外鞘、膀胱镜外鞘辅助手段治疗膀胱结石,对两组方法的手术效率、安全性等方面进行临床评价比较。结果观察组平均手术时间（35.8±21.3）min,均一次碎石成功,无严重出血、严重尿外渗、尿道假道和膀胱破裂等并发症发生,无1例中转开放手术。术后合并泌尿系统感染3例,术后随访3~12个月,无远期并发症。对照组平均手术时间（55.6±20.7）min,术中有3例因膀胱破裂改行开放手术治疗,2例因术野尿道膀胱损伤出血视野模糊不清改行开放手术治疗,术后合并泌尿系统感染8例。结论该改良方式的工作通道适合,视野清晰,提高了工作效率和手术的安全性,有一定优势,为临床上治疗膀胱结石提供新的可能途径,具有一定的创新性、实用性价值。

【Objective】To investigate the curative effect through urethral minimally invasive rubble by a transparent hose for the treatment of benign prostatic hyperplasia complicated with bladder stones. 【Methods】 From February 2010 to February 2015, the bladder stone 2 cm case was selected in the patients with benign prostatic hyperplasia complicated with bladder stones. According to the bladder stone lithotripsy different ways were divided into two groups. The observation group of benign prostatic hyperplasia complicated with bladder stones was 86 patients used transparent hose for treatment of bladder stone. The control group was 48 patients used prostate gland electricity application cut sheath, cystoscope sheath to adjunct to the treatment of bladder stones. Compared clinical evaluation of operation efficiency, safety and other aspects of the two methods.【Results】The average operation time was（35.8 ± 21.3） min in the observation group. All cases were treated successfully, no severely bleeding, no severely urinary extravasation, no urethral false passage, no bladder rupture and no other complications. No cases were converted to open surgery. There were 5 postoperative patients with urinary system infection in all cases. The patients were followed up for 3 ~ 12 months, and they were no long-term complications. The average operation time was（55.6 ± 20.7） min in the control group. 3 cases were treated with open operation because of bladder rupture underwent. 2 cases converted to open operation treatment due to blurred vision because of urethral and bladder injury.There were 3 postoperative patients with urinary system infection in all cases. 8cases were complicated with urinary system infection after the operation.【Conclusion】The modified method is with suitable working channel and a clear field of vision. It is a certain advantage of improving the work efficiency and the operation safety. It may provide new way for the clinical treatment of bladder stones and the innovation of practical value.