3种微创手术方法经尿道治疗膀胱血凝块填塞的比较分析

Comparison of three transurethral minimally invasive operation for bladder blood block

目的比较电切镜、EMS肾镜和手术刨削器经尿道治疗膀胱内血凝块的手术效果。方法回顾性分析2010年5月-2015年5月46例患者经尿道微创治疗膀胱内血凝块的临床资料,其中采用电切镜清除膀胱内血凝块25例(电切镜组);采用EMS肾镜清除膀胱内血凝块11例(肾镜组);采用手术刨削器治疗膀胱内血凝块10例(刨削器组),比较3种治疗方法的临床效果。结果 46例患者膀胱内血块均被彻底清除,其中35例同期采用电切镜处理了出血点或出血病灶,3组血块清除效率(7.57±2.25)ml/min vs(11.43±4.06)ml/min vs(12.11±4.24)ml/min,P<0.05。肾镜组和刨削器组血块清除效率均明显高于电切镜组(P<0.05),刨削器组效率最高,但与肾镜组差异无统计学意义(P>0.05)。结论应用EMS肾镜和手术刨削器清除膀胱内巨大血凝块效率高,电切镜在清除血块后处理出血病灶上更方便快捷。

Objective To compare the efficacy and safety of resectoscopy, EMS nephroscopy and rotating cutter for bladder blood block. Methods Resectoscope（25 cases）, EMS nephroscopy（11 cases） and operative rotating cutter（10 cases） were used to treating bladder blood block. The operative effect was investigated. Results All the bladder blood block was eliminated successfully. The blood-eliminating efficiency was（7.57 ± 2.25） ml/min vs（11.43 ± 4.06）ml/min vs（12.11 ± 4.24） ml/min, P〈0.05. EMS nephroscopy and operative rotating cutter were both more efficient than resectoscopy. Conclusion EMS nephroscopy and rotating cutter for bladder blood filling is convenient, safe and effective.