老年前列腺增生合并巨大膀胱结石微创手术经验分析  

Experience of minimally invasive surgery for the elderly patients with benign prostatic hyperplasia complicated with giant bladder calculi

作　　者：黄喜健[1] 冯小兰[2] 卢国平 HUANG Xi-jian;FENG Xiao-lan;LU Guo-ping(Department of Urology,Guangxi Nationalities Hospital,Nanning 530001,China;Department of Pathology,Guangxi Nationalities Hospital,Nanning 530001,China)

机构地区：[1]广西医科大学附属民族医院泌尿外科,广西壮族自治区南宁市530001 [2]广西医科大学附属民族医院病理科,广西壮族自治区南宁市530001

出　　处：《实用老年医学》2020年第2期167-170,共4页Practical Geriatrics

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2015104)

摘　　要：目的比较分析我院治疗老年前列腺增生合并巨大膀胱结石(直径>4 cm)2种微创手术方式的疗效。方法收集2015年10月至2018年10月我院前列腺增生合并巨大膀胱结石病人45例,根据不同手术方式分为2组。A组23例应用F20大通道肾镜联合等离电切镜外鞘经尿道气压弹道碎石术+等离子前列腺剜除术(PKEP),B组22例行PKEP+耻骨上膀胱切开取石术,观察并比较2组手术时间、术中情况、术后恢复情况、住院时间、术后3个月残余尿量(PVR)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)。结果A组手术时间较B组长,术后留置导尿管时间和切口愈合不良例数均少于B组,差异有统计学意义(P<0.05)。A组术后住院时间明显短于B组,差异有统计学意义(P<0.05)。术后3个月,2组IPSS分别为(6.0±0.9)分、(6.0±0.8)分,均较满意;2组间PVR和QOL评分比较差异无统计学意义(P>0.05)。结论大通道肾镜联合等离电切镜外鞘经尿道气压弹道碎石术+PKEP治疗老年前列腺增生合并巨大膀胱结石安全有效、创伤小、住院时间短、疗效好,值得推广。Objective To compare the efficacy of two minimally invasive surgical procedures for the elderly patients with benign prostatic hyperplasia complicated with giant bladder calculi(diameter>4 cm)in our hospital.Methods From October 2015 to October 2018,45 case with benign prostatic hyperplasia complicated with giant bladder calculi in our hospital were enrolled and divided into two groups according to the different surgical methods.Group A(23 cases)was treated with F20 large channel nephrolithotomy combined with external electroscope,transurethral pneumatic lithotripsy and transurethral bipolar plasma kinetic enucleation of prostate(PKEP),group B(22 cases)was treated with PKEP and suprapubic cystolithotomy.The operation time,intraoperative condition,postoperative recovery,hospitalization time,residual urine volume(PVR),the scores of International Prostate Symptom Scale(IPSS)and Quality of Life Scale(QOL)were observed and analyzed.Results The operation time was significantly longer and the indwelling catheter time,length of stay,and the number of the cases with poor healing of incisions after operation were significantly less in group A than those in group B(P<0.05).Three months after the operation,the score of IPSS was satisfied in two groups and there was no significant difference in the PVR and score of QOL between the two groups(P>0.05).Conclusions Large-channel nephroscopy combined with transurethral pneumatic lithotripsy and PKEP in treatment of benign prostatic hyperplasia complicated with large bladder calculi in the elderly is safe and effective,with less trauma,shorter hospitalization time and better efficacy,which is worth popularizing.

关 键 词：前列腺增生 巨大膀胱结石 气压弹道碎石术 经尿道前列腺等离子剜除术 

分 类 号：R697.32[医药卫生—泌尿科学]