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目的:比较电切镜联合输尿管镜下气压弹道碎石术、肾镜下气压弹道碎石术及肾镜下EMS五代超声碎石清石系统手术等三种腔镜手术方法治疗膀胱结石的疗效。方法:回顾性分析我院2011年5月~2014年2月腔镜手术治疗膀胱结石122例患者的临床资料,其中采用电切镜联合输尿管镜下气压弹道碎石术(组1)治疗41例,肾镜下气压弹道碎石术(组2)治疗47例,肾镜下EMS五代超声碎石清石系统手术(组3)治疗34例。比较三组的疗效。结果:122例手术均成功,无严重出血、膀胱穿孔等并发症。组1碎石手术时间为5~63min,平均(29.9±14.1)min;组2碎石手术时间为12~63min,平均(32.1±13.9)min;组3碎石手术时间为5~42min,平均(20.5±8.9)min。组1总住院时间为6~17d,平均(11.4±2.7)d,组2为7~18d,平均(11.6±2.7)d;组3为7~17d,平均(11.6±2.8)d。术后随访1~24个月,无远期并发症。结论:三种腔镜手术治疗膀胱结石均安全、有效。肾镜下EMS五代碎石清石系统手术有碎石效率高、手术时间短等优点。
OBJECTIVE: To compare the curative effect of three endoscopic surgical procedures such as pneumatic lithotripsy combined with ureteroscopic pneumatic lithotripsy, pneumatic lithotripsy under nephrolithotomy and nephroscope EMS fifth generation ultrasound lithotripsy to treat bladder stones. Methods: A retrospective analysis of our hospital from May 2011 to February 2014 endoscopic surgical treatment of bladder stones in 122 patients with clinical data, including the use of resectoscope and ureteroscopic pneumatic lithotripsy (group 1) treatment of 41 cases , 47 cases underwent pneumatic lithotripsy (group 2) and 34 cases underwent nephroscope EMS (group 3). Compare the efficacy of the three groups. Results: All the 122 surgeries were successful without complications such as severe bleeding and bladder perforation. The operation time of group 1 was 5 ~ 63min (mean 29.9 ± 14.1) min. The operation time of group 2 was 12 ~ 63min (mean 32.1 ± 13.9) min. The operation time of group 3 was 5 ~ 42min (20.5 ± 8.9) min. In group 1, the total length of stay was 6 to 17 days, with an average of (11.4 ± 2.7) days. Group 2 was 7 to 18 days with an average of (11.6 ± 2.7) days. Group 3 was 7 to 17 days with an average of (11.6 ± 2.8) days. Postoperative follow-up 1 to 24 months, no long-term complications. Conclusion: The three kinds of endoscopic surgical treatment of bladder stones are safe and effective. Nephroscope EMS five generations of lithotripsy stone surgery system has high efficiency lithotripsy, short operative time and so on.