经尿道双极等离子电切术分别联合弹道碎石、膀胱小切口治疗前列腺重度增生合并膀胱结石的临床疗效

Clinical efficacy of TKRP combined with ballistic lithotripsy and small incision for the treatment of BPH with bladder stones

目的探讨经尿道双极等离子电切术(TKRP)分别联合弹道碎石、膀胱小切口治疗前列腺重度增生合并膀胱结石的临床疗效。方法我院90例前列腺重度增生合并膀胱结石患者,按随机数表法分为观察组与对照组各45例。观察组给予TKRP联合膀胱小切口,对照组给予TKRP联合弹道碎石,对比两组手术相关指标,比较国际前列腺症状量表(I-PSS)、生活质量指数(QOL)差异,记录术后输血率、中转手术发生率、残留结石发生率及并发症发生率。结果观察组总手术时间、碎石取石时间短于对照组(P<0.05)。两组术后均无输血。观察组中转手术发生率、残留结石发生率均显著低于对照组(P<0.05)。两组术后1个月I-PSS评分、QOL评分均低于术前,且观察组低于对照组(P<0.05)。两组并发症发生率差异无统计学意义(P>0.05)。结论 TKRP联合膀胱小切口治疗前列腺重度增生合并膀胱结石总手术时间、碎石取石时间,下尿路症状、生活质量改善程度优于弹道碎石,并发症少,可为临床治疗提供一定的指导意义。

Objective To analyze the clinical effect of transurethral bipolar plasmakinetic resection of the prostate （TKRP） combined with ballistic lithotripsy or small incision for the treatment of BPH with bladder stones. Methods Ninety patients with BPH complicated with bladder stones in our hospital randomly divided into the observation or control group,45 in each group. The observation group was treated with TKRP combined with small incision. The control group was given TKRP combined ballistic lithotripsy. The sur- gery related indicators, International Prostate Symptom Scale （I-PSS） and quality of life index （QOL）, rate of postoperative blood trans- fusion, incidence of recurrent operation, incidence of residual stones and incidence of complications were compared between the two groups. Results The total operation time and stone removal time in the observation group were shorter than those in the control group （P 〈 0. 05）. No blood transfusion was performed in the two groups. The incidence of operation and the incidence of residual stones in the observation group were significantly lower than those in the control group （ P 〈 0. 05）. The I-PSS score and QOL score after 1 month of operation in both groups were lower than those before operation, and the observation group was lower than that of the control group （P 〈 0.05）. There was no significant difference in complication rate between the two groups （P 〉 0.05）. Conclusion TKRP combined with small incision for the treatment of severe prostatic hyperplasia combined with bladder stones are better than ballistic lith- otripsy in the total operation time,time of stone removal,lower urinary tract symptoms and quality of life improvement. It also has fewer complications. It can provide some guidance for clinical treatment.