微创医学

目的探讨改良F18-F20膀胱镜鞘加输尿管镜气压弹道(或钬激光)碎石治疗膀胱结石的疗效。方法经改良的F18-F20膀胱镜鞘置入输尿管镜,采用气压弹道(或钬激光)将结石击碎,直视下用取石钳通过改良的膀胱镜鞘取出较大的结石碎块,再采用Ellick冲洗器将碎石吸尽。结果 33例膀胱结石,直径0.8～2.5 cm,平均1.3枚。一次性碎石成功率100%,手术时间15～60 min,平均30 min。无尿道损伤,无膀胱出血、穿孔、破裂,术后无膀胱、尿道感染。结论经改良膀胱镜鞘加输尿管镜气压弹道碎石治疗≤2.5 cm的膀胱结石具有微创、安全、手术时间短、并发症少等优点。

Objective To investigate the effect of ureteroscopic pneumatic ( or holmium laser ) lithotripsy using modified F18 － F20 cystoscope sheath for the bladder stones． Methods Ureteroscope was put through modified F18 － F20 cystoscope sheath into the bladder，then pneumatic ( or holmium laser) were used to crush stones，under direct vision large stone fragments were clamped out by a stone forceps through the modified cystoscope sheath，and the remained stone fragments were washed out by a Ellick． Results Stone diameter of 33 patients was ranged from 0． 8 to 2． 5cm，and average stone number was 1． 3 per patient． The stone clearance rate in one time was 100%，and the average operation time was 30 min ( 15 － 60 min) ，with no urethral injury，bladder bleeding，perforation，rupture，postoperative bladder，or urinary tract infection occurred． Conclusion The modified cystoscope sheath ureteroscopic pneumatic lithotripsy for bladder stones of ≤2． 5 cm is minimally invasive，safe，with shorter operative time and fewer complications．

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