目的 探討4種輸尿管鏡入鏡方法的成功率及對輸尿管口的損傷。 方法 回顧性分析2008年7月－2011年3月間行輸尿管鏡手術的患者共553例，按其入鏡方法分為4組，分別采用球囊擴張法、灌注泵加壓灌注入鏡法、內旋法及倒入法進行輸尿管鏡操作。分析其成功率及對輸尿管口的損傷。 結果 氣囊擴張法成功率為95%，但對輸尿管口的損傷率為100%；灌注泵加壓法成功率為67.5%，輸尿管口損傷率為87.0%；內旋法的成功率為87.9%，損傷率為50.0%；倒入法成功率91.0%，對輸尿管口損傷率為22.2%。4種方法中，灌注泵加壓法一次性成功率最低，與其余3種方法比較，差異均有統計學意義（P＜0.008）；其余3種方法間一次性成功率差異無統計學意義（P＞0.008）。對輸尿管口的損傷率，4種方法組間兩兩比較的差異均有統計學意義（P＜0.008），其中氣囊擴張法損傷率最高，倒入法最低。 結論 倒入法是4種方法中成功率較高且損傷小的一種方法。
A case of a 4-month-old child with an aortopulmonary fenestration weighing 6.6 kg who underwent successful transthoracic minimally invasive occlusion in our hospital was reported in this article. The child was transferred from the intensive care unit (ICU) to the general ward 1 day after surgery and discharged 5 days later. Compared with conventional ligation or repair of extracorporeal circulation for the aortopulmonary fenestration, the transthoracic minimally invasive occlusion is characterized by less trauma and faster recovery. However, it requires strict surgical indications and is not suitable for all patients with aortopulmonary fenestration.
【摘要】 目的 探討腎鏡結合氣壓彈道碎石治療膀胱結石的臨床療效。 方法 分析2004年9月－2011年3月男性膀胱結石患者87例的臨床資料。結石直徑1.5~6.7 cm，使用腎鏡結合氣壓彈道碎石術治療，統計手術時間、手術并發癥。隨訪3個月，觀察有無尿道狹窄。 結果 所有患者碎石成功，平均手術時間為37 min，無殘留結石，無膀胱穿孔、感染性休克、膀胱大出血等并發癥；術后3個月隨訪，經尿道手術者均未發現尿道狹窄。 結論 腎鏡下氣壓彈道碎石術是治療膀胱結石安全、有效的方法。【Abstract】 Objective To explore the clinical efficacy of pneumatic ballistic lithotripsy via nephroscope in treating patients with bladder stones. Methods We retrospectively analyzed the clinical data of 87 patients with bladder stones from September 2004 to March 2011. The diameter of the stones were ranged from 1.5 to 6.7 cm. The patients underwent peneumatic ballistic lithotripsy via nephroscope. We recorded the operation time and complications, and observed the incidence of urethrostenosis 3 months after the beginning of the follow-up. Results All stones were fragmented and removed successfully. The average operation time was 37 minutes. No residual stone, bladder perforation, infective shock or severe bleeding of the bladder occurred. During the 3-month follow-up, no utethrostenosis occurred. Conclusion Pneumatic ballistic lithotripsy via nephroscope is a safe and efficient technique in treating bladder stones.