于国盛 杨波 郝战宽 张世杰 王文斌

[摘要] 目的 探讨电切镜鞘辅助肾镜气压弹道碎石治疗膀胱结石的效果。 方法 选择我院2010年8月～2015年10月收治的186例膀胱结石患者，按照随机数字表法将患者分为观察组和对照组，每组93例。术前控制所有患者的基础疾病，改善其一般状况，同时行PKVP者按照PKVP术进行术前准备。观察组采用电切镜鞘辅助肾镜气压弹道碎石术，对照组采用单纯气压弹道碎石。 结果 观察组93例患者均一次清石成功，在手术时间、手术成功率、住院费用方面均明显优于对照组（P<0.05）；两组较大结石（直径>25 mm）的手术效果比较发现，观察组的手术成功率为100.0%，手术时间为（31.33±7.58）min，对照组分别为72.1%，（39.59±8.25）min，观察组在手术时间、手术成功率方面优于对照组（P<0.05）。 结论 电切镜鞘辅助肾镜气压弹道碎石治疗膀胱结石具有操作简单、清石效率高、手术时间短、使用器械价格便宜等优点，是治疗膀胱结石的理想方法。

[关键词] 电切镜；肾镜；气压弹道；膀胱结石

[中图分类号] R694+.4 [文献标识码] A [文章编号] 1674-4721（2016）03（b）-0031-04

Effect analysis of resectoscope sheath auxiliary kidney pneumatic ballistic lithotripsy treating bladder calculi

YU Guo-sheng YANG Bo HAO Zhan-kuan ZHANG Shi-jie WANG Wen-bin

Department of Urology，Central Hospital of Zhuanghe City in Liaoning Province，Zhuanghe 116400，China

[Abstract] Objective To investigate the effect of resectoscope sheath auxiliary kidney pneumatic ballistic lithotripsy treating bladder calculi. Methods 186 cases with bladder calculi treated by our hospital from August 2010 to October 2015 were selected，and they were divided into observation group （n=93） and control group （n=93） according to the random number table method.Before treatment，underlying disease of all patients was controlled and general condition of patients was improved，at the same time，patients conducted PKVP were given preoperative preparation according to PKVP operation.Observation group was treated by resectoscope sheath auxiliary kidney pneumatic ballistic lithotripsy，while control group was treated by simple pneumatic ballistic lithotripsy. Results 93 cases were given successful lithotripsy all at once in observation group，and in the aspect of operative time，success rate of operation，hospitalization cost，observation group was significantly better than that of control group （P<0.05）.The operation effect of larger stone （diameter>25 mm） compared between two groups showed that the success rate of observation group was 100.0%，the operation time was （31.33±7.58） min，while control group was 72.1%，（39.59±8.25） min respectively，and in the aspect of operative time，success rate of operation，observation group was significantly better than that of control group （P<0.05）. Conclusion Resectoscope sheath auxiliary kidney pneumatic ballistic lithotripsy treating bladder calculi has the advantages of simple operation，high stone clearance efficiency，short operation time，cheap used equipment price and so on，and it is is the ideal method of treating bladder calculi.

[Key words] Resectoscope；Nephroscope；Pneumatic lithotripsy；Bladder calculi

膀胱结石是泌尿科常见病，成人膀胱结石多见于男性，尤其是前列腺良性增生合并膀胱结石患者，发病率>10%[1]。临床治疗膀胱结石大多依赖膀胱镜完成，但膀胱镜工作通道狭窄，冲洗液流速缓慢，视野不够清晰，因此，碎石时间往往较长，膀胱内压较高，容易诱发菌血症以及造成膀胱损伤[2]。随着医学诊疗技术的不断发展，肾镜下碎石取石术在膀胱结石治疗中的应用越来越广泛，具有省时、效率高等优势。本研究选取我院采用电切镜鞘辅助肾镜气压弹道碎石处理膀胱结石93例，取得满意效果。

1 资料与方法

1.1 一般资料

选择我院2010年8月～2015年10月收治的186例膀胱结石患者，所有患者均经B超、膀胱CT检查后确诊。按……