肾镜下经尿道气压弹道-超声碎石清石术治疗下尿路结石的临床观察

摘要

Objective:To investigate the efficacy and safety of nephrolithotomy transurethral pneumatic lithotripsy and ultrasonic lithotripsy for the treatment of lower urinary tract stones.Method:A total of 78 lower urinary tract stone patients in our hospital from July 2013 to July 2014 were selected,they were treated with nephrolithotomy transurethral pneumatic ballistic ultrasonic lithotripsy,among them 67 cases were bladder stones,the diameter was 1.1-3.0 cm,the mean diameter was 2.5 cm.11 cases were urethral calculi,the diameter was 0.5-1.8 cm,the mean diameter was 1.2 cm. 2 cases were bladder stones complicated with urinary tract stones,17 cases were single stone,15 cases were two stones,46 cases were multiple calculi (the maximum number was 8 stones).The treatment of all patients were observed.Result:All patients were treated successfully once,the success rate was 100%,no case appeared bladder perforation or laceration of urethra.The time of lithotripsy bladder stones was 12-60 min,the average was 28.6 min, the time of urethral calculi lithotripsy was 10-20 min,the average was 15.5 min,the postoperative catheter indwelling time was 1-7 d,the average was 4.5 d.The length of hospitalization was 1-8 d,the average was 5 d.Conclusion:The advantages of nephrolithotomy transurethral pneumatic lithotripsy and ultrasonic lithotripsy for the treatment of lower urinary tract stones are safe,effective,less trauma,fewer complications,exact effect,is worthy of clinical promotion.%目的：探讨肾镜下经尿道气压弹道-超声碎石清石术治疗下尿路结石的疗效与安全性。方法：选取笔者所在医院2013年7月-2014年7月收治的78例下尿路结石患者，均采用肾镜经尿道行气压弹道-超声碎石清石术治疗，其中膀胱结石67例，直径为1.1~3.0 cm，平均2.5 cm，尿道结石11例，直径0.5~1.8 cm，平均1.2 cm；膀胱结石与尿道结石并发2例，单发结石17例，两个结石15例，多发结石46例(最多8枚结石)。观察所有患者的治疗情况。结果：所有患者均一次碎石成功，成功率100%，无一例出现膀胱穿孔、尿道撕裂。膀胱结石碎石时间为12~60 min，平均28.6 min。尿道结石碎石时间10~20 min，平均15.5 min。术后导尿管留置时间1~7 d，平均4.5 d，住院时间1~8 d，平均5 d。结论：肾镜下经尿道气压弹道-超声碎石清石术治疗下尿路结石具备安全、高效、创伤小等优点，并发症少，疗效确切，值得临床推广。