经尿道肾镜下超声碎石治疗后尿道嵌顿结石效果分析

Effect Analysis of Ultrasonic Lithotripsy in Treating Posterior Urethra-stuck Stones Under Transurethral Nephroscope

目的评价经尿道肾镜下超声碎石在治疗后尿道嵌顿结石中的临床意义。方法随机选取2006~2015年行腔镜下治疗的男性后尿道嵌顿结石52例,均已尝试用尿道探条将结石推入膀胱失败,其中2011年后行经尿道肾镜下超声碎石治疗的26例作为观察组,2011年前行经尿道输尿管镜下气压弹道碎石治疗的26例作为对照组,分别比较两组间患者的手术时间、术中出血并发症发生情况。结果 52例手术均成功完成。观察组与对照组的平均手术时间分别为（22±6）min,（36±9）min,术中出血并发症例数分别为2例、15例,两组对比差异均有统计学意义（P=0.001〈0.05）。结论经尿道肾镜下超声碎石治疗男性后尿道嵌顿结石手术时间短、术中出血并发症少,效果明显优于输尿管镜下气压弹道碎石。

Objective To assess the clinical significance of ultrasonic lithotripsy in treating posterior urethra-stuck stones under transurethral nephroscope. Methods 52 cases of male patients with posterior urethrastuck stones treated under endoscope from 2006 to 2015 were randomly chosen, and all of them had failed attempts at pushing stones into the bladder by urethral bougies. Among them, 26 cases treated by ultrasonic lithotripsy under transurethral nephroscope since 2011 were chosen as the observation group, and 26 cases treated by pneumatic lithotripsy under transurethral nephroscope before 2011 were the control group. Then the paper made comparisons of patients＇ duration of operation, occurrence of intraoperative bleeding complications between the two groups respectively. Results 52 cases of operations were successfully completed. As to the observation group and the control group, the mean operation time of them were（22±6） min and（36±9） min respectively, and the case with bleeding complications were 2 and 15 respectively. These difference between the two groups showed statistical significance（P=0.0010.05）. Conclusion With respect to the treatment of posterior urethra-stuck stones of male patients, the effect of ultrasonic lithotripsy under transurethral nephroscope is obviously better than that of pneumatic lithotripsy under ureteroscope, as the former has shorter operation time and less intraoperative bleeding complications.