尿道前列腺切除术联合经尿道膀胱取石治疗老年前列腺增生伴膀胱结石的疗效及预后  

Efficacy and prognosis of urethral prostatectomy combined with transurethral lithotomy for the treatment of senile prostatic hyperplasia with bladder calculus

作　　者：王安勇[1] 高余杰 黄学东 张衡 朱杰 Wang Anyong;Gao Yujie;Huang Xuedong;Zhang Heng;Zhu Jie(Department of Urology,People's Hospital of Ya'an City,Sichuan 625000,China)

机构地区：[1]四川省雅安市人民医院泌尿外科,四川雅安625000

出　　处：《中国临床医生杂志》2024年第3期290-294,共5页Chinese Journal For Clinicians

基　　金：四川省卫生和计划生育委员会科研课题(17PJ034)。

摘　　要：目的探讨经尿道前列腺切除术(TURP)联合经尿道膀胱取石治疗老年前列腺增生伴膀胱结石患者的疗效及其预后。方法以2018年6月至2022年2月于四川省雅安市人民医院就诊的老年前列腺增生伴膀胱结石患者为研究对象,选取其中采用TURP+经尿道膀胱取石术治疗的72例患者为观察组,选取采用TURP+小切口膀胱切开取石术治疗的70例患者为对照组。比较两组患者手术指标、C反应蛋白(CRP)、淀粉样蛋白A(SAA)、去甲肾上腺素(NE)水平,比较两组患者术前及术后3个月后国际勃起功能指数问卷表-5(ILEF-5)、中国早泄患者性功能评价表(CIPE)、国际前列腺症状评分(I-PSS)、膀胱过度活动症患者自我评价表(OAB-SS)、良性前列腺增生症病人生活质量量表(BPHQLS)及残余尿量(PVR)、最大尿流率(Q_(max))、前列腺特异性抗原(PSA)水平及术后3个月内并发症发生情况。结果观察组患者取石时间、术中出血量、膀胱冲洗时间、尿管留置时间均明显低于对照组(P<0.05);术后1 d,两组患者CRP、SAA、NE均较术前明显上升,且对照组明显高于观察组(P<0.05);术后3个月,两组患者Q_(max)水平较术前明显上升,且观察组明显高于对照组(P<0.05);术后3个月,两组患者OAB-SS、BPHQLS评分、PVR、PSA水平均较术前明显下降,且观察组明显低于对照组(P<0.05);术后3个月,两组患者ILEF-5、CIPE评分均较术前明显上升(P<0.05),但观察组与对照组比较差异无统计学意义(P>0.05);术后3个月,两组患者I-PSS评分较术前明显下降(P<0.05),但观察组与对照组比较差异无统计学意义(P>0.05);术后3个月内,观察组患者并发症总发生率明显低于对照组(P<0.05)。结论TURP+经尿道膀胱取石术与TURP+小切口膀胱切开取石术均对老年前列腺增生伴膀胱结石患者具有较好的治疗效果,可有效改善患者前列腺及膀胱功能,但TURP+经尿道膀胱取石术对患者伤害更小,患者预后较好,且�Objective To explore the efficacy and prognosis of trans-urethral Resection of the Prostate(TURP)combined with transurethral lithotomy for the treatment of senile prostatic hyperplasia with bladder calculus.Method The study focuses on elderly patients of prostatic hyperplasia with bladder calculus who visited our hospital from June 2018 to February 2022.72 patients treated with TURP+transurethral lithotomy were selected as the observation group,and 70 patients treated with TURP+small incision lithotomy were selected as the control group.The levels of surgical indicators,C-reactive protein(CRP),serum amyloid A(SAA)and norepinephrine(NE)were compared between the two groups.The international index of erectile function-5(ILEF-5),Chinese index of sexual function for premature ejaculation(CIPE),international prostate symptom score(I-PSS),and overactive bladder syndrome score(OAB-SS),Qquality of life scale for BPH patients(BPHQLS),residual urine volume(PVR),maximum flow rate(Q_(max)),prostate specific antigen(PSA)level of patients with benign prostatic hyperplasia were compared between the two groups before and 3 months after surgery,and the incidence of complications within 3 months after surgery.Result The observation group had significantly lower stone removal time,intraoperative bleeding volume,bladder flushing time,and urinary catheter retention time compared to the control group(P<0.05);On the 1st day after surgery,CRP,SAA,and NE in both groups were significantly increased,and the control group was significantly higher than the observation group(P<0.05);Three months after surgery,the level of Q_(max) in both groups were significantly increased compared to before surgery,and the observation group was significantly higher than the control group(P<0.05);Three months after surgery,the levels of OABSS,BPHQLS score,PVR,and PSA in both groups were significantly lower than before surgery,and the observation group was significantly lower than the control group(P<0.05);After 3 months of surgery,the ILEF-5 and CIPE scores of

关 键 词：前列腺增生 膀胱结石 经尿道前列腺切除术 经尿道膀胱取石术 

分 类 号：R699.6[医药卫生—泌尿科学]