经尿道前列腺汽化电切术联合钬激光碎石术同期治疗良性前列腺增生症合并膀胱结石的临床效果

Clinical effect of simultaneous treatment of TUVP and YAG laser for BPH patients accompany with bladder stone

目的 探讨经尿道前列腺汽化电切术联合钬激光碎石术同期治疗良性前列腺增生症合并膀胱结石的临床效果。方法 回顾性分析2012年1月~2016年1月榆林市第一医院泌尿外科收治的300例良性前列腺增生症合并膀胱结石患者临床资料,根据治疗方式不同进行分组,对照组（经尿道前列腺汽化电切术联合气压弹道碎石治疗）150例和观察组（经尿道前列腺汽化电切术联合钬激光碎石术治疗）150例。观察两组患者手术前后国际前列腺症状评分（IPSS评分）、最大尿流率（Qmax）、残余尿量（RUV）、生理状态、心理状态、社会功能状态、主观判断评分情况;比较两组患者术后并发症发生情况。结果 两组患者术前IPSS评分、Qmax、RUV、生理状态、心理状态、社会功能状态、主观判断评分比较,差异均无统计学意义（P〉0.05）;术后两组IPSS评分、RUV均低于术前,Qmax、生理状态、心理状态、社会功能状态、主观判断评分均高于术前,且观察组IPSS评分、RUV较对照组降低更明显,Qmax、生理状态、心理状态、社会功能状态、主观判断评分较对照组升高更明显,差异均有统计学意义（P〈0.05）;观察组患者术后无并发症发生,且无复发病例,而对照组术后泌尿系感染5例（3.3%）,结石残留3例（2.0%）,尿道狭窄3例（2.0%）,复发3例（2.0%）。结论 经尿道前列腺汽化电切术联合钬激光碎石术治疗可以改善良性前列腺增生症合并膀胱结石患者的临床症状和生活质量,安全性高,值得临床推广应用。

Objective To approach clinical curative effect of simultaneous treatment BPH accompany with bladder stone by TUVP and YAG laser. Methods Clinical data of 300 patients with BPH accompany with bladder stone from January 2012 to January 2016 in Department of Urinary Surgery, the First Hospital of Yulin City were retrospectively analyzed, according to different treatment methods, they were divided into control group （TUVP combined with pneu- matic ballistic lithotripsy） 150 cases and observation group （TUVP combined with YAG laser） 150 cases. The IPSS score, Qmax, RUV, physiological status, psychological states, social function, subjective judgment score of two groups were compared before and after operation; the rate of postoperative complications of the two groups were compared. Results The IPSS score, Qmax, RUV, physiological status, psychological states, social function, subjective judgment score of two groups before operation had no statistically significant difference （P 〉 0.05）; the IPSS score, RUV of two groups after operation were lower than before operation, Qmax, physiological status, psychological states, social func- tion, subjective judgment score were higher than before operation, and the IPSS score, RUV of the observation group were obviously lower than those of the control group; Qmax, physiological status, psychological states, social function, subjective judgment score were higher obviously than those of the control group, the differences were statistically signif- icant （P 〈 0.05）. In the observation group, all the patients without the postoperative complications and no relapse cases, while there were 5 cases （3.3%） of postoperative urinary tract infection, 3 cases （2.0%） of stone residues, 3 cases （2.0%） of urinary tract stenosis, and recurrence in 3 eases （2.0%） in the control group. Conclusion The simultaneous treatment of TUVP and YAG laser can improve the clinical symptoms and living quality of patients with BPH accom- pany with bladder stone, with high security, it is worthy of clinical application.