同期腔内手术治疗输尿管中下段结石合并前列腺增生疗效观察

Therapeutic effect of simultaneous endoscopic surgery for the treatment of lower or middle ureteral calculi and benign prostate hyperplasia

目的探讨同期腔内手术治疗输尿管中下段结石合并前列腺增生的有效性及安全性。方法回顾性分析重庆医科大学附属第二医院泌尿外科2016年1月至2018年7月收治的68例输尿管中下段结石合并前列腺增生患者的临床资料,其中同期手术组32例,分期手术组36例。比较两组患者的碎石成功率、手术时间、住院时间、并发症发生率及术后3个月的前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿量(PVR)等指标的差异。结果同期组与分期组患者在手术时间[(118.03±14.56) min vs (122.36±11.23) min]、碎石成功率(90.6%vs94.4%)、并发症发生率(18.8%vs 11.1%)方面比较,差异均无统计学意义(P>0.05);但同期组患者的总住院时间为(9.85±1.18) min,明显短于分期组的(14.05±1.03) min,且差异有统计学意义(P<0.05);同期组与分期组患者术后3个月的IPSS[(5.22±1.84)分vs (5.56±2.16)分]、QOL [(1.34±0.83)分vs (1.53±0.91)分]、Qmax[(18.72±2.04) m L vs (19.28±2.65) m L]及PVR [(22.63±13.15) m L vs (28.58±17.30) m L]比较,差异均无统计学意义(P>0.05)。结论同期腔内手术治疗输尿管中下段结石合并前列腺增生是安全、有效的,但术前应充分评估患者的病情,严格把握手术适应证。

Objective To investigate the efficacy and safety of simultaneous endoscopic surgery for the treatment of patients with lower or middle ureteral calculi combined with benign prostate hyperplasia. Methods A retrospective analysis was performed on the clinical data of 68 patients with ureteral calculi and benign prostate hyperplasia who were treated in the Department of Urology at the Second Affiliated Hospital of Chongqing Medical University during January 2016 and July 2018, including 32 cases in the simultaneous operation group and 36 cases in the staged operation group. The stone-free rate, operative time, hospital stay, complication rate and 3-month postoperative international prostate symptom score(IPSS), quality of life(QOL), maximum flow rate(Qmax), post-void residual(PVR) urine volume were compared between the two groups. Results There were no significant difference between the two groups with regard to operative time(118.03±14.56)min vs(122.36±11.23) min, stone-free rate(90.6% vs 94.4%), and rate of complication(18.8% vs 11.1%), P>0.05. However, the total length of hospital stay for patients was(9.85±1.18) min in the simultaneous group, which was significant shorter than(14.05±1.03) min in the staged group(P<0.05). The data of a3-month follow-up showed that IPSS(5.22±1.84 vs 5.56±2.16), QOL(1.34±0.83) vs(1.53±0.91), Qmax(18.72±2.04) mL vs(19.28±2.65) mL and PVR(22.63±13.15) m L vs(28.58±17.30) mL had no significant differences between the two groups(P>0.05). Conclusion Simultaneous endoscopic surgery is safe and effective in the treatment of lower or middle ureteral calculi and benign prostate hyperplasia. However, the patient’s condition should be fully evaluated before surgery, and surgical indications should be strictly controlled.