耻骨上小切口膀胱切开取石联合经尿道前列腺切除术治疗良性前列腺增生症合并膀胱结石的临床研究  

The clinical research of suprapubic small cut method combined with transurethral resection prostate on the treatment of benign prostatic hyperplasia complicated with bladder stones

作　　者：吴炜嘉 夏昕晖[1] 李梅[1] 黄彩辉[1] 姜海洋[1] 郑汉雄[1] 

机构地区：[1]广东医学院附属福田人民医院泌尿外科,深圳518000

出　　处：《中国综合临床》2016年第4期328-331,共4页Clinical Medicine of China

基　　金：深圳市福田区卫生公益性科研项目（FTWS2014009）

摘　　要：目的探讨耻骨上小切口膀胱切开取石联合经尿道前列腺切除术（TURP）在治疗良性前列腺增生症（BPH）合并膀胱结石方面的临床疗效。方法选取2013年1月至2014年9月期间我院泌尿外科收治的60例合并膀胱结石≥13cm的BPH患者作为试验组，另选取我院同期收治的60例合并膀胱结石〈3cm的BPH患者作为对照组。试验组患者采用耻骨上小切口膀胱切开取石联合TURP术进行膀胱结石碎石取石治疗，对照组患者采用经尿道腔内碎石取石联合TURP术进行治疗，比较两组患者的术中指标（包括碎石取石所用的时间、总的手术时间、术中出血量、中转开腹情况、输血情况以及膀胱穿孔等）、术后膀胱结石的残留情况和术后并发症的发生情况。结果两组患者手术过程顺利，术中均未行中转开腹治疗，也未发生膀胱穿孔等不良情况。试验组患者术中碎石取石所用的时间[（12．20±3．55）min与（24．05±7．68）min]以及总的手术时间[（62．31±10．49）min与（82．46±16．75）min]较对照组少，差异均有统计学意义（t值分别为10．849、7．897，P均〈0．001），而试验组患者术中出血量和输血例数虽较对照组患者有所减少，术后出现泌尿系感染（6例）较对照组（4例）有所增多，但差异均无统计学意义（P均〉0．05）；试验组患者一周后复查B超未发现结石残留，而对照组患者复查B超时发现仍有6例残留少许结石，两组患者比较差异有统计学意义（0与10％，χ2=6．316，P=0．012）。结论耻骨上小切口膀胱切开取石联合TURP术和经尿道腔内碎石取石联合TURP术两种手术方式均能有效治疗BPH合并膀胱结石患者，但是耻骨上小切口膀胱切开取石联合TURP术更加安全有效，值得在临床上推广应用。Objective To explore the clinical effect of suprapubic small cut method combined with transurethral resection prostate （TURP） on the treatment of benign prostatic hyperplasia（ BPH ） complicated with bladder stones. Methods Sixty patients with BPH complicated with bladder stones ≥ 3 cm in the People＇s Hospital of Futian Affiliated to Guangdong Medical College from January 2013 to September 2014 were selected as the study group,and another 60 patients with BPH complicated with bladder stones〈3 cm during the same period were selected as the control group. The cases in the study group were treated with suprapubic small cut method combined with TURP, and the cases in control group were treated with transurethral method combined with TURP. The intraoperative indicators （ including the time used for crushed stone, total operation time, blood loss,conversion to laparotomy, blood transfusion and bladder perforation ） , residual bladder stones and complications of postoperative were compared. Results The operations of the two groups of patients were successfully, and there was no conversion to laparotomy and either bladder perforation. The stone removal time and total operative time of patients of the study group were shorter than of the control group, the difference was statistically significant（ （ 12. 20±3.55） min vs. （24. 05±7.68） min, （62. 31± 10.49） min vs. （ 82. 46± 16. 75） min;t = 10. 849,7. 897 ;P〈0. 001 ） . The intraoperative blood loss and the cases of blood transfusion of patients ofthe study group were less than the control group, but the prevalence of urinary tract infection were higher （6 vs. 4 ） ,but the difference was not statistically significant（ P〉0. 05） . Residual stones were more commonly in the control group than in the study group （ study group： 0, control group： 6 cases） , the difference was statistically significant（ χ2= 6. 316,P= 0. 012） . Conclusion BPH complicated with bladder stones can be treated by the suprapubie small cut met

关 键 词：耻骨上小切口膀胱切开取石 经尿道前列腺切除术 良性前列腺增生症 膀胱 结石 

分 类 号：R697.32[医药卫生—泌尿科学]