一种可控膀胱压力简易装置在前列腺中叶增生并膀胱结石治疗中的应用  

Controllable bladder pressure:introduction to a simple self-made device in the treatment of hyperplasia of median lobe of prostate and bladder stones

作　　者：陈腾锋 胡姗姗 谢庆祥 苏旭东 洪达铭 CHEN Teng-feng;HU Shan-shan;XIE Qing-xiang;SU Xu-dong;HONG Da-ming(Zhangzhou Zhengxing Hospital,Zhangzhou 363000,China)

机构地区：[1]漳州正兴医院,福建漳州363000

出　　处：《现代泌尿外科杂志》2020年第12期1124-1127,共4页Journal of Modern Urology

摘　　要：目的介绍一种可维持膀胱低压的简易自制装置,并探讨其在治疗前列腺中叶增生并膀胱结石的临床应用价值。方法介绍我们的自制装置,回顾漳州正兴医院收治的前列腺中叶增生并膀胱结石27例患者的资料,手术方式是同期应用经尿道前列腺等离子电切术(TURP)治疗中叶增生的前列腺,再应用简易自制的膀胱低压装置连接电切镜鞘和输尿管镜气压弹道碎石治疗膀胱结石。结果26例一次手术成功,无中转开放手术、无输血、无经尿道前列腺电切综合征(TURS)及严重感染等并发症发生。1例高危患者因术中低氧血症行二期手术。27例术后3个月复查,无尿失禁、尿道狭窄等并发症发生,尿路平片未见结石复发;与术前比较,术后3个月国际前列腺症状评分[(7.1±1.4)分vs.(26.0±1.9)分,t=44.243,P=0.000],生活质量评分[(1.3±0.9)分vs.(5.3±0.7)分,t=16.821,P=0.000],残余尿量[0(0~21)mL vs.40(0~303)mL,Z=-3.920,P=0.000],差异均有统计学意义。结论此装置制作简便,用于前列腺中叶增生合并膀胱结石安全有效,基层医院可参考开展。Objective To introduce a simple self-made device to control bladder pressure and to explore its clinical application in the treatment of hyperplasia of median lobe of prostate and bladder stones.Methods A total of 27 cases of hyperplasia of median lobe of prostate and bladder stones were treated in our hospital with transurethral resection of prostate(TURP)first,and then the self-made device was used to connect ureteroscope sheath in pneumatic ballistic lithotripsy.Results All operations were successful,with no conversion to open surgery and no blood transfusion.No complications such as transurethral resection syndrome or severe infections occurred.One high-risk patient underwent secondary surgery due to intraoperative hypoxemia.Three months after operation,no urinary incontinence,urethral stricture or other complications were observed,and no recurrence of calculi was found in urography.The international prostatic syndrome score(IPSS)rose from(7.1±1.4)to(26.0±1.9),t=44.243,P=0.000;the Quality of Life(QoL)score rose from(1.3±0.9)to(5.3±0.7),t=16.821,P=0.000;residual urine volume(RUV)dropped from 40(0~303)mL to 0(0~21)mL,Z=-3.920,P=0.000.Conclusion The self-made device is simple,safe and effective in the treatment of hyperplasia of median lobe of prostate and bladder stones in primary hospitals.

关 键 词：前列腺增生 膀胱结石 经尿道前列腺电切术 气压弹道碎石 膀胱压力 

分 类 号：R694[医药卫生—泌尿科学]