前列腺腔内剜除联合膀胱小切口术治疗高龄重度良性前列腺增生(BPH)合并膀胱结石的疗效  

Efficacy of Endoprostatic Enucleation Combined with Small Bladder Incision in the Treatment of Aged Severe Benign Prostatic Hyperplasia(BPH) Complicated with Bladder Stones

作　　者：郭昌平[1] GUO Changping(Department of Urology,Second Hospital of Sanming,Sanming,Fujian Province,366000 China)

机构地区：[1]三明市第二医院泌尿外科,福建三明366000

出　　处：《中外医疗》2022年第28期74-78,共5页China & Foreign Medical Treatment

摘　　要：目的研究膀胱结石合并重度良性前列腺增生(benign prostatic hyperplasia,BPH)高龄患者应用前列腺腔内剜除联合膀胱小切口术治疗的效果。方法方便选取三明市第二医院于2020年1月—2021年8月收治的154例重度BPH合并膀胱结石高龄患者为研究对象,按手术方案不同分为对照组(77例)与研究组(77例),对照组行经尿道前列腺电切术(transurethral resection of prostate,TURP)联合弹道碎石术治疗,治疗组行前列腺腔内剜除联合膀胱小切口术治疗。对比两组围术期指标、膀胱功能、症状改善情况及生活质量评分。结果研究组术中出血量少于对照组,研究组手术、住院、导尿管留置及术后膀胱冲洗时间均短于对照组,差异有统计学意义(t=14.630、6.104、9.756、12.398、57.210,P<0.05);研究组术后3个月PVR水平为(45.21±4.06)mL,低于对照组的(65.87±6.33)mL,Qmax水平为(23.36±2.44)mL/s,高于对照组(18.77±3.41)mL/s,差异有统计学意义(t=24.107、9.605,P<0.05);与对照组比较,研究组术后3个月IPSS评分、QOL评分更低,差异有统计学意义(t=7.321、3.479,P<0.05)。结论膀胱结石合并重度良性BPH高龄患者应用前列腺腔内剜除联合膀胱小切口术治疗具有出血量少、用时短、恢复快等优势,可改善患者症状,促进生活质量提高。Objective To study the effect of endoluminal enucleation combined with small bladder incision in elderly patients with bladder stones and severe benign prostatic hyperplasia(BPH).Methods Conveniently selected 154 elderly patients with severe BPH complicated with bladder stones who were admitted to Sanming Second Hospital from January 2020 to August 2021 as the research subjects,and were divided into control group(77 cases)and research group(77 cases)according to different surgical plans.The control group received transurethral resection of the prostate(TURP)combined with lithotripsy,while the treatment group received endoluminal enucleation combined with small bladder incision.The perioperative indicators,bladder function,symptom improvement and quality of life scores were compared between the two groups.Results The intraoperative blood loss in the study group was less than that in the control group,and the operation,hospitalization,catheter indwelling and postoperative bladder irrigation time in the study group were all shorter than those in the control group,and the differences were statistically significant(t=14.630,6.104,9.756,12.398,57.210,P<0.05);the PVR level of the study group was(45.21±4.06)mL at 3 months after operation,which was lower than that of the control group(65.87±6.33)mL,the Qmax level was(23.36±2.44)mL/s,higher than the control group(18.77±3.41)mL/s,the difference was statistically significant(t=24.107,9.605,P<0.05);compared with the control group,the study group was 3 months after the operation The IPSS score and QOL scorewere lower,and the difference was statistically significant(t=7.321,3.479,P<0.05).Conclusion In elderly patients with bladder calculi and severe benign BPH,endoprostatic enucleation combined with small bladder incision has the advantages of less bleeding,shorter time,faster recovery,etc.,which can improve the symptoms of patients and promote the improvement of quality of life.

关 键 词：前列腺腔内剜除 联合治疗 高龄患者 膀胱小切口术 膀胱结石 重度良性前列腺增生 

分 类 号：R4[医药卫生—临床医学]