低压CO_2气膀胱下膀胱结石气压弹道碎石术的临床效果

The clinical application of pneumatic(ballistic)lithotripsy in the treatment of bladder calculi under low pressure CO_2 gas bladder

目的探讨在低压CO_2气膀胱的条件下行经尿道气压弹道碎石术的疗效。方法通过收集2014年9月至2016年5月我科收治的43例膀胱结石患者进行低压CO_2气膀胱条件下气压弹道碎石术,测定安全性指标膀胱黏膜损伤例数、膀胱壁损伤例数、导尿管留置时间等安全性指标及碎石时间、结石残留情况(是或否)等有效性指标。结果经尿道低压CO_2气膀胱下膀胱结石气压弹道碎石术碎石时间(3.17±2.02)min,无膀胱黏膜出血、膀胱壁损伤及中转开放手术病例,术后单纯膀胱结石术后留置尿管时间平均(2.69±1.61)d,术后随访1个月无结石残留或复发病例。结论低压CO_2气膀胱法下膀胱结石经尿道气压弹道碎石术处理膀胱结石,具有方法简单易行、视野清晰、无膀胱壁及黏膜损伤风险,碎石效率高,治疗效果确切,值得在各级医院泌尿外科临床推广应用。

ObjectiveTo evaluate the safety and efficacy of pneumatic （ballistic） lithotripsy in the treatment of bladder calculi under low pressure CO2 gas bladder. MethodsA total of 43 patients with bladder stones were treated with transurethral pneumatic （ballistic） lithotripsy under low pressure CO2 gas bladder. The number of patients whose bladder mucosa and bladder wall were damaged were recorded. Periorperative data including time of catheterization，time to break stones，residual calculi were assessed. ResultsThe average time needed to break calculi was 3.17 min. During the procedure，no patients had bladder mucosa bleeding，bladder wall damage or converted to open surgery. The average catheterization time was 3.65 d. No patients had residual calculi or recurrence 1 month after the surgery. ConclusionsIt is simple，safe，effective and efficient to treat bladder calculi with pneumatic （ballistic） lithotripsy under low pressure CO2 gas bladder. This method is worthy of wide application.