经尿道双极等离子剜除联合耻骨上小切口治疗高危高龄前列腺增生合并膀胱结石  

Transurethral plasmakinetic enucleation of prostate and suprapubic small cut in the treatment ofhigh risk and senior patient with benign prostatic hyperplasia and bladder stones

作　　者：余小祥 张瑞明 周大庆 莫曾南[2] 李文刚 王强 王坚 江波 邓程慧 庞翔 

机构地区：[1]解放军第三〇三医院泌尿外科,南宁530021 [2]广西医科大学第一附属医院泌尿科学研究所

出　　处：《中华医学杂志》2013年第8期597-599,共3页National Medical Journal of China

摘　　要：目的探讨经尿道双极等离子前列腺剜除（TUPKEP）联合耻骨上小切口治疗高危高龄前列腺增生（BPH）合并膀胱结石的安全性和疗效。方法回顾分析解放军第三。三医院收治的68例采用TUPKEP联合耻骨上小切口手术方式治疗的高危高龄BPH合并膀胱结石患者的临床资料。结果68例患者均顺利完成手术，术中术后无电切综合征、休克、心肌梗死、脑梗死、脑出血、永久性尿失禁、切口感染等并发症。暂时性尿失禁7例，平均恢复时间（9．48±1．52）d。平均手术时间（48．63±4．14）min，术中平均出血量（50．97±5．33）ml。与术前相比，术后最大尿流率（Qmax），国际前列腺症状评分（I-PSS），生活质量评分（QOL）差异均有统计学意义。术前术后Qmax分别为（4．56±0．35）ml／s和（18．82±1．65）mL／s（P〈0．001）。术前术后I-PSS分别为（21．96±1．89）分和（11．23±0．86）分（P=0．018）。术前术后QOL分别为（4．94±0．35）分和（1．95±0．32）分（P=0．011）。结论TUPKEP联合耻骨上小切口治疗高危高龄BPH合并膀胱结石安全有效。Objective To explore the safety and efficiency of transurethral plasmakinetic enucleation of prostate （TUPKEP） and suprapubie small cut in the treatment of high-risk and senior patients with benign prostatic hyperplasia and bladder stones. Methods A retrospective review was conducted for 68 high-risk and senior patients with benign prostatic hyperplasia and bladder stones. All of them were treated by TUPKEP and suprapubic small cut. Results Operation was successfully performed in all 68 cases. And there was no instance of transurethral resection syndrome, shock, myocardial infarct, cerebral infarction, cerebral hemorrhage, permanent urinary incontinence or surgical site infection. Seven patients with temporal urinary incontinence recovered at a mean time of （9. 48 ± 1.52） days post-operation. The mean operative duration was （48. 63±4. 14） rain and the mean volume of blood loss （50. 97±5. 33） ml. The changes of maximum flow rate （Qmax）, international prostatic symptom score （I-PSS） and quality-of-life （QOE） were statistically significant before and after operation. Qmax increased from （4. 56 ± 0. 35 ） to （ 18. 82 ± 1.65 ） ml/s （P 〈0.001）, I-PSS decreased form （21.96 ±1.89） to （11.23 ±0. 86） （P =0.018） and QOL decreased from （4.94±0.35） to （1.95 ±0.32） （P=0.011）. Conclusion The approach of TUPKEP and suprapubic small cut is both safe and effective in the treatment of high-risk and senior patient with benign prostatic hyperplasia and bladder stones and should be widely applied.

关 键 词：前列腺增生 膀胱结石 手术 治疗 

分 类 号：R699[医药卫生—泌尿科学]