前列腺增生合并膀胱结石同期微创手术的疗效  

作　　者：林云侨[1] 陈从其[1] 林忠应[1] 

机构地区：[1]福建医科大学附属宁德市医院泌尿外科,福建352100

出　　处：《当代医学》2015年第25期4-6,共3页Contemporary Medicine

摘　　要：目的探讨气压弹道超声系统联合经尿道前列腺等离子电切术同期治疗前列腺增生(BPH)合并膀胱结石的疗效。方法选择41例BPH合并膀胱结石患者,术前根据尿流动力学测定将其分为轻、中、重度梗阻组,分别为11、23、7例,采用气压弹道超声系统联合经尿道前列腺等离子电切术,比较3组患者术前术后的前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿以及逼尿肌不稳定(DI)、逼尿肌低顺应性、逼尿肌活动低下(DUA)、逼尿肌一括约肌协同失调(DSD)的发生率。结果 41例患者手术均成功,无并发症,术后3个月3组患者的IPSS、QOL、Qmax、残余尿均较术前显著改善,术后DI、DUA、DSD及低顺应性发生率均较术前显著降低,差异均有统计学意义(P<0.01)。结论同期经尿道膀胱结石碎石术和PKRP联合治疗BPH伴膀胱结石是安全高效且微创的手术方法,可明显改善患者的梗阻症状,有效清除结石,提高生活质量。Objective To probe the effective treatment for patients with Begin Prostate Hyperplasia （BPH） along with Cystolith with Plasmakinetic Resection of Prostate Combining with Transurethral Cystolithotripsy by Pneumatic and Ultrasound Lithotripsy. Methods 41 cases of patients of BPH combined with Cystolith were chosen. Before operation, chosen patients were divided into three groups which were light obstruction, medium obstruction and sever one, based on the urodynamics,with eleven, twenty three and seven cases respectively. Plasmakinetic Resection of Prostate Combining with Transurethral Cystolithotripsy by Pneumatic and Ultrasound Lithotfipsy was used to compare the prostate symptom score （IPSS）, quality of life score （QOL）, maximal urinary flow rate （Qmax）, residual urine and detrusor instability （DI）, detrusor low compliance, detrusor underactivity （DUA） and the incidence of detmsor sphincter dyssynergia （DSD） in those three groups of patients before and after operations. Results All operations in 41 cases were successful, without any complication. Three months after operations, IPSS, QQL, Qmax, and residual urine were significantly improved in three groups of patients. DI, DUA, DSD and low compliance rate of occurrence decreased markedly. These differences contribute to the medical statistics. Conclusion Simultaneous transurethral bladder calculi lithotripsy combined with with PKRP is considered as the safe, effective and minimal invasive surgical method to cure BPH along with Cystolith, also obviously improving the symptoms of obstruction, effectively removing calculus and improving the quality of life.

关 键 词：前列腺增生 膀胱结石 PKRP 

分 类 号：R699[医药卫生—泌尿科学]