经尿道前列腺汽化电切术联合钬激光碎石术治疗前列腺增生合并膀胱结石的效果  

Effect of transurethral resection of the prostate combined with holmium laser lithotripsy on benign prostatic hyperplasia complicated with bladder stones

作　　者：汪海洋 董成 王锡清 WANG Haiyang;DONG Cheng;WANG Xiqing(Department of Urology,Dexing People's Hospital,Shangrao,Jiangxi,334200,China;Department of General Surgery,Dexing Second People's Hospital,Shangrao,Jiangxi,334224,China)

机构地区：[1]德兴市人民医院泌尿外科,江西上饶334200 [2]德兴市第二人民医院普外科,江西上饶334224

出　　处：《当代医学》2023年第33期34-37,共4页Contemporary Medicine

摘　　要：目的探讨经尿道前列腺汽化电切术(TURP)联合钬激光碎石术(HLL)治疗前列腺增生(BPH)合并膀胱结石的效果。方法选取2019年1月至2021年6月德兴市人民医院收治的60例BPH合并膀胱结石患者作为研究对象,按照随机数字表法分为对照组与观察组,每组30例。对照组行TURP联合气压弹道碎石术(PL)治疗,观察组行TURP联合HLL治疗。比较两组围手术期指标、碎石效果、前列腺症状[国际前列腺症状量表(IPSS)]及膀胱功能[残余尿量(RVU)、最大尿流率(Qmax)]、生命质量[健康调查简表(SF-36)评分]。结果观察组术中出血量少于对照组,手术时间短于对照组,差异有统计学意义(P<0.05);两组留置尿管时间、膀胱冲洗时间、住院时间比较差异无统计学意义。观察组直径≥2 cm结石碎石时间短于对照组,单次碎石率高于对照组,差异有统计学意义(P<0.05);两组直径<2 cm结石碎石时间及单次碎石率比较差异无统计学意义。术后3个月,两组IPSS评分均低于术前,RVU少于术前,Qmax高于术前,且观察组IPSS评分低于对照组,RVU少于对照组,Qmax高于对照组,差异有统计学意义(P<0.05)。术后3个月,两组心理状态、生理状态、社会功能、主观判断评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论TURP联合HLL可有效提高BPH合并膀胱结石患者结石清除率,减轻尿道梗阻情况,促进前列腺功能恢复,且手术创伤小,进而可促进患者术后恢复,改善生命质量,值得临床推广应用。Objective To explore the effect of transurethral resection of the prostate(TURP)combined with holmium laser lithotripsy(HLL)in the treatment of benign prostatic hyperplasia(BPH)complicated with bladder stones.Methods 60 patients with BPH complicated with bladder stones admitted to Dexing People's Hospital from January 2019 to June 2021 were selected as the research subjects,and they were divided into the control group and the observation group according to the random number table method,with 30 cases in each group.The control group was treated with TURP combined with pneumatic lithotripsy(PL),while the observation group was treated with TURP combined with HLL.The perioperative indicators,lithotripsy effect,prostate symptoms(international prostate symptom score[IPSS])and bladder function(relative value unit[RVU],maximum flow rate[Qmax])and quality of life(36-item short form health survey[SF-36])were compared between the two groups.Results The blood loss in the observation group was less than that in the control group,and the operation time was shorter than that in the control group,and the differ-ences were statistically significant(P<0.05).There were no significant differences in indwelling catheter time,bladder irrigation time and hospitalization time between the two groups.The time of lithotripsy for stones with diameter≥2 cm in the observation group was shorter than that in the control group,and the rate of single lithotripsy was higher than that in the control group,and the differences were statistically significant(P<0.05).There were no significant differences between the two groups in the time of lithotripsy for stones with diameter<2 cm and the rate of single lithotripsy.3 months after operation,the IPSS score of the two groups were lower than that before operation,RVU were lower than that before operation,and Qmax were higher than that before operation,and the IPSS score in observation group was lower than that in the control group,RVU was less than that in the control group,and Qmax was higher than tha

关 键 词：前列腺增生 膀胱结石 经尿道前列腺汽化电切术 气压弹道碎石术 尿动力学 

分 类 号：R699.8[医药卫生—泌尿科学]