经尿道等离子电切联合膀胱碎石取石术治疗高龄高危前列腺增生合并膀胱结石

Transurethral plasmaknetic resection combined with lithotriptoscopy in the treatment of high risk and senior patients with benign prostatic hyperplasia and bladder stones

目的：探讨经尿道前列腺等离子电切术联合膀胱碎石取石术一期治疗高龄高危前列腺增生合并膀胱结石的治疗方法。方法回顾性分析63例高龄高危前列腺增生合并膀胱结石患者的临床资料，ASA麻醉风险评估Ⅱ级14例，Ⅲ级49例：所有患者采用经尿道前列腺等离子电切术联合膀胱结石碎石取石术。结果手术时间40～120 min，平均56．1 min，未发生前列腺包膜穿孔、膀胱穿孔、输尿管口损伤、出血和周围脏器损伤等并发症。术后留置尿管5～16 d，平均7．1 d，随访3～24个月，国际前列腺症状评分（IPSS 评分）由术前（26．3±7．2）分下降至术后（11．9±5．1）分，生活质量指数（QOL）由（4．6±1．1）下降至（2．6±0．8），差异均有统计学意义（t ＝38．206、49．017，均 P ＜0．001）。结论经尿道前列腺等离子电切术联合膀胱碎石取石术是治疗高龄前列腺增生合并膀胱结石一种安全有效的方法。

Objective To investigate the efficacy of transurethral plasmakinetic resection combined with transurethral bladder calculi lithotripsy in treating benign prostatic hyperplasia（BPH）and bladder calculi in patients with advanced age and high risk.Methods Retrospectively analyzed the clinical data of 63 patients with BPH com-bined with bladder calculi belonged to the levelⅡ,while the other 49 patients level Ⅲ,according to American Society of Anesthesiologists（ASA）classification of disease assessment criteria.All patients were treated by transurethral plas-makinetic resection combined with transurethral bladder calculi lithotripsy.Results The operative duration was 40-120min（mean 56.1min）,ntubation time was 5-16d（mean 7.1d）.3-24 months after operation,IPSS decreased from preoperative （26.3 ±7.2）points dropped to postoperative （11.9 ±5.1）points,index of quality of life（QOL）from （4.6 ±1.1 ）dropped to （2.6 ±0.8）,the differences were statistically significant（t =38.206,49.017,all P 〈0.001）.Conclusion Transurethral plasmakinetic resection combined with ransurethral bladder calculi lithotripsy is a secure and efficient option for advanced age and high risk patients with BPH and bladder calculi.