目的 探讨4种输尿管镜入镜方法的成功率及对输尿管口的损伤。 方法 回顾性分析2008年7月－2011年3月间行输尿管镜手术的患者共553例，按其入镜方法分为4组，分别采用球囊扩张法、灌注泵加压灌注入镜法、内旋法及倒入法进行输尿管镜操作。分析其成功率及对输尿管口的损伤。 结果 气囊扩张法成功率为95%，但对输尿管口的损伤率为100%；灌注泵加压法成功率为67.5%，输尿管口损伤率为87.0%；内旋法的成功率为87.9%，损伤率为50.0%；倒入法成功率91.0%，对输尿管口损伤率为22.2%。4种方法中，灌注泵加压法一次性成功率最低，与其余3种方法比较，差异均有统计学意义（P＜0.008）；其余3种方法间一次性成功率差异无统计学意义（P＞0.008）。对输尿管口的损伤率，4种方法组间两两比较的差异均有统计学意义（P＜0.008），其中气囊扩张法损伤率最高，倒入法最低。 结论 倒入法是4种方法中成功率较高且损伤小的一种方法。
【摘要】 目的 探讨肾镜结合气压弹道碎石治疗膀胱结石的临床疗效。 方法 分析2004年9月－2011年3月男性膀胱结石患者87例的临床资料。结石直径1.5~6.7 cm，使用肾镜结合气压弹道碎石术治疗，统计手术时间、手术并发症。随访3个月，观察有无尿道狭窄。 结果 所有患者碎石成功，平均手术时间为37 min，无残留结石，无膀胱穿孔、感染性休克、膀胱大出血等并发症；术后3个月随访，经尿道手术者均未发现尿道狭窄。 结论 肾镜下气压弹道碎石术是治疗膀胱结石安全、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.
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.