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目的:探讨膀胱造瘘加自制水封(防水帽)经电切镜外鞘输尿管镜气压弹道碎石联合大力碎石钳碎石治疗膀胱大结石(>2.5 cm)的疗效。方法:膀胱造瘘下经尿道置入电切镜外鞘,套上自制水封,输尿管镜经水封沿电切镜外鞘气压弹道碎石联合大力钳碎石治疗膀胱大结石55例,22例合并BPH,其中有18患者同期行经尿道前列腺电切术(TURP)。结果:患者均一次碎石成功,无严重出血、严重尿外渗、尿道假道、膀胱破裂等并发症发生,无一例中转开放手术。术后随访3～12个月,无远期并发症。结论:该方法具有安全可靠、损伤小、手术时间短、并发症少、适应证广的优点。
Objective: To investigate the curative effect of bladder fistula plus self-made water seal (waterproof cap) treated with lithotripsy and ureteroscopic pneumatic lithotripsy combined with strong lithotripter lithotripsy in the treatment of large urolithiasis (> 2.5 cm). Methods: Transurethral transurethral resection of cystostomy was performed, and a self-made water seal was placed on the transurethral resection of the bladder. 55 cases of large urolithiasis were treated with pneumatic lithotripsy and pliers forceful lithotripsy through a ureteroscope. Cases combined with BPH, of which 18 patients underwent transurethral resection of the prostate (TURP). Results: All the patients were successfully treated with gravel, no serious bleeding, serious urinary extravasation, urethral false passage, bladder rupture and other complications. None of the patients underwent open surgery. Postoperative follow-up of 3 to 12 months, no long-term complications. Conclusion: The method has the advantages of safety and reliability, less injury, shorter operation time, fewer complications and wide indications.