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目的:探讨经尿道2μm激光治疗膀胱结石的疗效和安全性。方法:2012年1月~2013年7月应用经尿道2μm激光治疗膀胱结石患者30例,分析患者术前资料及围术期情况,术后分析结石成分,并对碎石效率进行评价。结果:30例患者均顺利完成手术。平均手术时间(25±5)min,碎石过程几乎无出血。膀胱冲洗时间(12~24)h,留置尿管时间1~2d,患者术后均未输血。术后感染发烧1例,经抗感染治疗好转。结石成分主要以草酸钙、尿酸及羟基磷灰石为主,平均碎石出光时间(14.7±5.4)min,平均出光功率(30.30±1.65)kJ。术后随访2~6个月,均无结石残留及复发。结论:经尿道2μm激光碎石术具有碎石率及排石率高、手术创伤小、术后恢复快、操作简单、易于掌握等优点,是一种安全、有效、微创的治疗方法,有较好的应用前景,值得临床推广应用。
Objective: To investigate the efficacy and safety of transurethral 2 μm laser treatment of bladder stones. Methods: From January 2012 to July 2013, 30 patients with bladder stones treated by transurethral 2μm laser were studied. Preoperative data and perioperative period were analyzed. The composition of the stones was analyzed after operation, and the lithotripsy efficiency was evaluated. Results: All 30 patients completed the operation smoothly. The average operation time (25 ± 5) min, the gravel process almost no bleeding. Bladder flushing time (12 ~ 24) h, indwelling catheter time 1 ~ 2d, patients were not transfused after surgery. Postoperative fever in 1 case, the anti-infective treatment improved. The main components of calculi are calcium oxalate, uric acid and hydroxyapatite. The average gravel output time (14.7 ± 5.4) min and the average output power (30.30 ± 1.65) kJ. All the patients were followed up for 2 to 6 months without any residual stones and recurrence. Conclusion: Transurethral 2 μm laser lithotripsy is a safe, effective and minimally invasive treatment with the advantages of high rate of gravel and high rate of stone removal, less trauma to the operation, quick recovery after operation, simple operation and easy to grasp. Better application prospects, it is worth clinical application.