局麻下李逊肾镜激光碎石术治疗膀胱结石疗效分析

Efficacy Analysis of Li Xun Nephroscope Laser Lithotripsy under Topical Intraurethral Anesthesia for Bladder Stones

摘要: 目的：探讨局部尿道内麻醉下经尿道李逊肾镜钬激光碎石术治疗膀胱结石的临床疗效。方法：回顾性分析2022年6月至2024年9月期间暨南大学附属第一医院收治的14例接受局部尿道内麻醉下李逊肾镜钬激光碎石术治疗膀胱结石患者的临床资料，分析其治疗效果。结果：14例患者均为男性，平均年龄(71.00 ± 10.59)岁，11例为单发结石，3例为多发结石，结石直径大小为(0.8~2.1) cm。手术耐受性良好，所有患者均顺利完成手术，结石清除率100%，平均手术时间(42.64 ± 10.03)分，平均术中视觉模拟评分2.35 ± 0.49，术中无膀胱活动性出血或尿道损伤等并发症。平均术后初次下床活动时间(24.21 ± 3.68)分，平均术后住院时间(1.78 ± 0.57)天。术后仅1例患者出现短暂发热，经保守治疗后热退。平均3个月的随访所有患者均无膀胱结石复发和尿道狭窄发生。结论：局部尿道内麻醉下李逊肾镜钬激光碎石术治疗膀胱结石是安全、有效的。

Abstract: Objective: To investigate the clinical efficacy of transurethral holmium laser lithotripsy for bladder stones using the Li Xun nephroscope under topical intraurethral anesthesia. Methods: We retrospectively analyzed clinical data from 14 patients with bladder stones who underwent holmium laser lithotripsy using the Li Xun nephroscope under topical intraurethral anesthesia at the First Affiliated Hospital of Jinan University from June 2022 to September 2024, and the therapeutic outcomes were evaluated. Results: All 14 patients were male, with a mean age of 71.00 ± 10.59 years. Eleven cases had single stones, and 3 had multiple stones, with stone diameters ranging from 0.8 to 2.1 cm. All procedures were well tolerated, with a 100% stone-free rate. The mean operative time was 42.64 ± 10.03 minutes, and the mean intraoperative Visual Analog Scale was 2.35 ± 0.49. No complications, such as active bladder bleeding or urethral injury, occurred during surgery. The mean time to first ambulation postoperatively was 24.21 ± 3.68 minutes, and the mean postoperative hospital stay was 1.78 ± 0.57 days. One patient developed transient postoperative fever, which resolved with conservative treatment. During a mean follow-up of 3 months, no recurrence of bladder stones or urethral stricture was observed. Conclusion: Transurethral holmium laser lithotripsy using the Li Xun nephroscope under topical intraurethral anesthesia is a safe and effective approach for bladder stones.