摘要
目的 探讨钬激光划线网格碎石联合等离子电切镜外鞘冲石法在大体积膀胱结石治疗中的手术效果.方法 收集2018年4月至2020年12月本院收治的38例行经尿道钬激光碎石手术的膀胱单发结石患者的临床资料.根据手术方式不同分为划线网格碎石组(试验组)和传统蚕食碎石组(对照组),每组各19例.统计并分析两组的手术总时间、碎石时间、术后即刻结石清除率、拔管后结石清除率、术后发热等并发症发生率等指标.结果 38例均手术成功,无中转改开放手术,试验组的手术总时间明显少于对照组(P=0.002);试验组的碎石时间明显少于对照组(P=0.003);试验组的术后即刻结石清除率与拔管后结石清除率明显高于对照组(P<0.001).对照组1例术后出现发热,最高达38.9℃,加强抗感染治疗后治愈出院.结论 针对大体积膀胱结石,行钬激光划线网格碎石联合等离子电切镜外鞘冲石法具有明显缩短碎石时间,提高结石清除率,同时不增加术后并发症等优点.
Objective To investigate the surgical efficacy of holmium laser scriping grid lithotripsy combined with plasma resectable lithotripsy with outer sheath in the treatment of large volume bladder stones.Methods A total of 38 patients with single bladder stone who underwent transurethral holmium laser lithotripsy from April 2018 to December 2020 were collected.According to the different surgical methods,the patients were divided into the scratched grid lithotripsy group(experimental group)and the traditional mow lithotripsy group(control group),with 19 cases in each group.The total operation time,lithotripsy time,immediate postoperative stone clearance rate,stone clearance rate after extubation,postoperative fever and other complications of the two groups were statistically analyzed.Results All 38 cases were successfully operated,and there was no transition to open surgery.The total operation time of the experimental group was significantly less than that of the control group(P=0.002),and the time of lithotripsy in the experimental group was significantly shorter than that of the control group(P=0.003).The immediate stone removal rate and the final stone removal rate of the experimental group were significantly higher than those of the control group(P<0.001).One case in the control group developed fever after opertion with the highest temperature of 38.9 C,and was cured and discharged after anti-infection treatment.ConclusionssFor large-volume cases of bladder stones,holmium laser scribing grid lithotripsy combined with plasma resectoscope outer sheath stone flushing method can shorten the lithotripsy time,improve the stone removal rate,and do not increase the advantages of postoperative complications.
作者
杨先俊
李恩源
马继涛
Yang Xianjun;Li Enyuan;Ma Jitao(Department of Urology,Pukou Branch,Jiangsu Provincial People's Hospital,Nanjing 211800,China)
出处
《国际泌尿系统杂志》
2023年第2期228-231,共4页
International Journal of Urology and Nephrology
关键词
膀胱结石
电切镜外鞘
钬激光
碎石术
Urinary Bladder Calculi
Outer Sheath of Electrosurgical Scope
Holmium Laser
Lithotripsy
