腔镜下同时处理输尿管结石及前列腺增生的可行性研究

Feasibility study of endoscopic simultaneous treatment of ureteral calculi and benign prostatic hyperplasia

目的研究输尿管镜钬激光碎石术(URHL)与经尿道双极等离子前列腺电切术(PKRP)同期治疗输尿管结石(UC)伴前列腺增生(BPH)的可行性,减少术后并发症。方法对2014年1至至8月收治的43例UC伴BPH患者前瞻性同期实施URHL及PKRP(同期组),回顾性分析2013年5月至12月收治的先行URHL,后择期行PKRP的40例UC伴BPH患者(二期组)的临床资料,比较2组预后。结果同期组手术时间、住院时间短于二期组2次手术合计手术时间及住院时间(P<0.05),出血量也少于二期组2次手术合计出血量(P<0.01);同期组2例置镜失败,2例未能碎石;2组术后国际前列腺症状评分、最大尿流率、残余尿量、并发症发生率比较差异无统计学意义(P>0.05)。结论腔镜下同期处理UC及BPH与二期手术处理疗效相当,且无严重并发症,但术前应严格评估患者耐受性,提高手术技术,确保手术成功。

Objective To investigate the feasibility of simultaneous underwent ureteroscope holmium laser lithotrity（URHL） and bipolar plasma kinetic resection of the prostate（PKRP） of ureteral （UC） and benign prosta‐tic hyperplasia（BPH） ,so as to reduce postoperative complications.Methods Forty‐three cases of pateints with UC and BPH in January to August 2014 （the simultaneous group）simultaneous underwent URHL and PKRP ,a retro‐spective analysis of clinical data of 40 cases of pateints with UC and BPH in May to December 2013 （the staging group ）which were treated first URHL ,after elective PKRP ,compared prognosis.Results Operative time ,hospi‐tal stay time of the simultaneous group was shorter than that in the staging group （ P 〈0 .05） ,but also the a‐mount of bleeding was less than the staging group（ P〈0 .01）;2 patients in the simultaneous group failure to mir‐ror set ,2 patients failure to rubble;international prostate symptom score （IPSS） ,maximum flow rate （Qmax） , postvoid residual volume （PRV） ,complications rate between two group ,the difference was not statistically signifi‐cant （ P〉0 .05） .Conclusion simultaneous treatment of UC and BPH as efficacy as staging surgical ,and no seri‐ous complications ,but preoperative assessment of the patient should be strictly tolerance ,improve surgical tech‐niques to ensure successful operation.