摘要
目的评价经尿道输尿管镜下第四代碎石清石系统（EMS）治疗成人尿道结石并急性尿潴留的疗效。方法应用输尿管镜下第四代EMS治疗成人因尿道结石所致急性尿潴留患者31例。全部为男性。平均年龄为41.3岁。结石直径0.4~1.8 cm。硬膜外麻醉下行经尿道输尿管镜下气压弹道加超声碎石清石术。电视监视下,应用Wolf 8.0~9.8F输尿管镜,通过操作通道置入EMS弹道碎石探杆或超声探针,将尿道结石完全粉碎并吸出。术中灌注泵压力为180~220 kPa,平均为200 kPa。超声碎石能量为60%~80%,占空比为70%~90%,平均为80%。术后均留着F18双腔导尿管1~3 d,平均1.2 d。结果 31例平均手术时间为21 min,均能在输尿管镜下一次性粉碎及清除结石,术后1~3 d拔除尿管,均能顺利排尿。拔除尿管后复查B超,未见结石残留。结论成人尿道结石并急性尿潴留患者急诊经尿道输尿管镜下应用第四代EMS清除结石,能迅速、简单、安全高效解除急性下尿路梗阻,具有损伤小、恢复快的优点,可作为临床上成人尿道结石并急性尿潴留急诊解除下尿路梗阻的首选方法。
Objective To evaluate the fourth generation rubble stone clearance system （EMS） in the Ireatment of adult urethral stones and acute urinary retention. Methods Thirty-one male patients, aged 47.3 years averagely, with acute urinary retention due to urethral stones, were treated with EMS under ureteroscope. Stone diameters were 0.4 ~1.8 crn. Ure- teroseope pneumatic lithotripsy and Canadian the ultrasonic lithotripsy lithotomy was employed under epidural anesthe- sia. Wolf 8.0--9.8F ureteroscope was placed in the EMS the lithotripsy probe or ultrasound probe through the operating channel, and urinary tract stones completely shattered and sucked out. Intraoperative infusion pump pressure were 180~220 kPa, with an average of 200 kPa. The ultrasonic lithotripsy Power was 60~,6 to 80%, the duty cycle was 70% to 90%, with an average of 80%. The F18 double-lumen catheter had been kept for 1 to 3 days, with an average of 1.2 days, after opera- tion. Results Mean operative time was 21 minutes, all the stones could be crushed and cleared, and catheter was re- moved after 1 to 3 days, with no residual stones. Conclusion The fourth generation of EMS is quick, simple, safe and effective to treat acute lower urinary tract obstruction caused by urethral stone.
出处
《海南医学》
CAS
2013年第24期3699-3701,共3页
Hainan Medical Journal
关键词
成人
尿道结石
输尿管镜
碎石术
Adult
Urethral calculi
Urcteroscope
Lithotripsy
