前列腺增生合并膀胱、输尿管结石的同期微创治疗  

Minimal invasive techniques for benign prostatic hyperplasia （ BPH ） combined with urethral/bladder calculi

作　　者：周振玉 张永 王广宁 

机构地区：[1]徐州市六院泌尿外科,江苏221006

出　　处：《国际泌尿系统杂志》2011年第4期449-451,共3页International Journal of Urology and Nephrology

摘　　要：目的总结前列腺增生并膀胱或输尿管结石的治疗方法及疗效。方法回顾性分析198例BPH合并膀胱结石（112例）、输尿管结石（86例）患者的临床资料及随访结果。结果输尿管结石均采用输尿管镜下气压弹道碎石、清石；膀胱结石分别采用一期电切环直径勾出（11例）、大力碎石钳碎石（15例）、耻骨上经膀胱气压弹道碎石（9例）、经尿道气压弹道碎石（31例）、耻骨上小切口取石（24例）同期联合经尿道前列腺电切和体外超声波碎石后TURP（22例）治疗。所有患者均一次性治疗成功。术中无膀胱及输尿管穿孔、无电切综合征发生、输血及中转开放手术病例，无结石残留；术后6个月国际前列腺症状评分和最大尿流率较术前均有显著改善，无尿道狭窄及迟发出血等。结论各种微创治疗均安全、满意。方法选择应根据患者具体情况及结石大小综合分析，结合医疗条件及术者技能，采取个体化治疗措施。Objectives To investigate the treatments and clinical effect for BPH combined with urethral/ bladder calculi. Methods The clinical data of 198 cases of BPH combined with bladder calculi（ 112 cases） and urethral calculi（86 cases） underwent minimal invasive techniques were reviewed retrospectively. Results Mini- mal invasive techniques were：combination of transurethral resectian of the prostate（ TURP）, all urethral calculi cases were treated with Ureteroscopic pneumatic lithotripsy（UPL） ;bladder calculi were treated with techniques： transurethral cystolithotripsy（ n = 15 ）, mini - incisions cystolithotomy （ n = 24）, suprapubic ballistic lithotripsy （ n = 9 ）, transurethral ballistic lithotripsy （ n = 31 ） ; extracorporeal shock wave lithotripsy （ESWL） and then TURP （ n = 22 ）. All the operations were successful,there were no post -operation vesical pei＇foration, no transurethral resection symptom （Tuns） , no blood transfusion, no open surgery cases, no residual calculi, and no other severe complications. After a follow up of six months,the international prostatic symptom score（IPSS） and maximum flow rate（MFR） were significantly improved, urinary incontinence and calculi recurrence, delayed blood loss were not found. Conclusions Several minimal invasive techniques were safe and effective,the option is second to synthetic data of patient,diameter of calculi and medical apparatus and instruments.

关 键 词：前列腺增生 膀胱结石 输尿管结石 

分 类 号：R699[医药卫生—泌尿科学]