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良性前列腺增生患者膀胱结石的体外冲击波碎石术

[Extracorporeal shock-wave lithotripsy of bladder stones in patients with benign prostatic hyperplasia].

作者信息

Trapeznikova M F, Urenkov S B, Kulachkov S M, Bazaev V V, Morozov A P

出版信息

Urologiia. 2001 Jan-Feb(1):20-2.

Abstract

In urological department of Moscow Regional Research Clinical Institute, extracorporeal shock-wave lithotripsy (ECSWL) or bladder stones in patients with benign prostatic hyperplasia (BPH) has been made prior to TUR from 1991. This treatment was given to 52 patients aged 54-79 years with prostatic volume 40-120 cm3. Complete or partial fragmentation of the vesical calculi was achieved after 1 to 3 ECSWL sessions (a total of 105 sessions, 2000-3000 impulses a session). Pretreatment with ECSWL of bladder stones significantly facilitates TUR in BPH patients with vesical calculi of big size (2.5 cm and more in diameter). Extracorporeal fragmentation of large stones prior to TUR makes surgery of such patients less traumatic and reduces the risk of intraoperative complications compared to endoscopic cystolithotripsy or cystolithotomy. ECSWL of cystolithes expands indications for drug therapy or thermal non-endoscopic BPH treatment in aged patients with poor somatic status and in young sexually active males rejecting surgery.

摘要

自1991年起,莫斯科地区研究临床研究所泌尿外科就对良性前列腺增生(BPH)患者在经尿道前列腺切除术(TUR)前进行体外冲击波碎石术(ECSWL)或治疗膀胱结石。该治疗应用于52例年龄在54至79岁、前列腺体积为40至120 cm³的患者。经过1至3次ECSWL治疗(共105次治疗,每次2000 - 3000次脉冲)后,膀胱结石实现了完全或部分破碎。对于患有大尺寸膀胱结石(直径2.5 cm及以上)的BPH患者,术前采用ECSWL治疗膀胱结石可显著便于进行TUR。与内镜下膀胱碎石术或膀胱切开取石术相比,TUR前对大结石进行体外破碎可使此类患者的手术创伤更小,并降低术中并发症的风险。对于身体状况较差的老年患者以及拒绝手术的年轻性活跃男性,膀胱结石的ECSWL扩大了药物治疗或非内镜热疗BPH的适应症。

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