前列腺增生症合并膀胱结石的治疗方法选择  

Investigate the Best Procedures for Benign Prostatic Hyperplasia Patients with Bladder Stones

作　　者：程支利[1] 陈智彬[1] 付承忠[1] 谢云峰[1] 吕天兵[1] 

机构地区：[1]四川省内江市第一人民医院泌尿外科,四川内江641000

出　　处：《中国医药科学》2011年第8期21-22,31,共3页China Medicine And Pharmacy

摘　　要：目的探讨BPH合并膀胱结石进行同期治疗更为有效的治疗方案。方法对笔者所在医院BPH合并膀胱结石患者64例,根据前列腺体积大小、膀胱结石直径及结石数量分别采用TUVP联合SCL治疗或TUVP联合腔内碎石取石术治疗;腔内碎石包括:OMC或PL两种。结果结石直径>3cm和(或)多发结石(>10枚)共8例,采用TUVP联合SCL,平均总手术时间(78.0±30.6)min,出血量约(35.6±23.2)mL;平均术后住院时间(6.2±2.1)d。膀胱结石<3cm和(或)少发结石(<10枚)共56例,采用TUVP联合OMC或PL治疗方案,平均总手术时间分别为(80.0±38.5)min、(86.0±20.3)min;平均出血量分别为(30.5±24.3)mL、(40.2±18.5)mL;平均术后住院时间分别为(5.7±4.8)d、(5.4±2.6)d。与两种腔内碎石比较,手术时间、出血量及住院时间,差异无统计学意义(P>0.05)。64例均一次手术成功,清石率100;术后随访3～6个月,排尿通畅,无结石复发。结论 BPH合并膀胱结石患者,结石较小和(或)少发者适合TUVP联合腔内碎石;结石较大和(或)多发以及前列腺Ⅲ～Ⅳ度大者适合TUVP联合SCL,均具有手术时间短、创伤小、操作简单及安全有效等优点。Objective To search for the more effective treatment over the same period for BPH in patients with bladder stones.Methods Totally 64 cases of patients having BPH with bladder stones were enrolled.According to the size of the prostate volume,bladder stone size and number of stones underwented by transurethral electrovaporization combined with OMC,SCL and PL.Results The stone diameter 3cm and（or） multiple stones（10 pills） were 8 cases,TUVP combined with SCL were underwent,mean total operating time was（78.0±30.6）min,blood loss was（35.6±23.2）mL,suprapubic catheter was removed 1 to 3 days,and the urethral catheter was removed 5 to 7 days postoperatively,the mean postoperative hospital stay was（6.2±2.1）days.56 cases with the stones diameter 3cm and（or） manipulus stones（10pills） were treated by TUVP combined with OMC or PL.The average operating time was（80.0±38.5）min and（86.0±20.3）min respectively,mean blood loss were（30.5±24.3）mL and（40.2±18.5）mL respectively.The urethral catheter was removed 3 to 5 days postoperatively and the average hospital stay after operation was（5.7±4.8）days and（5.4±2.6）days respectively.64 cases were complete stone clearance achieved and all were followed up for 3 to 6 months,with no urination unobstructed and no stone recurrence.Conclusion BPH with bladder stones,when the stones were small（diameter3cm） and（or） few（10 pills） were suit for TUVP combined with OMC or PL;when stones larger and（or） multiple or BPH（Ⅲ～Ⅳ degree） were suit for TUVP combined with SCL,the deferent treatment can shorten the operating time and are minimally invasive,simple,safe and effective.

关 键 词：前列腺增生 膀胱结石 经尿道前列腺汽化电切术 小切口 

分 类 号：R697.32[医药卫生—泌尿科学] R694.4[医药卫生—外科学]