前列腺增生合并膀胱结石的微创治疗效果分析

Minimally invasive in the treatment of BPH complicated with bladder stones

目的 观察微创手术对前列腺增生（benign prostate hyperplasia,BPH）合并膀胱结石的治疗效果.方法 以2014年5月至2015年10月在本院接受治疗的BPH合并膀胱结石的患者为观察对象.根据其手术方式,分为微创手术组（50例）和开放手术组（38例）.其中微创手术组采用经尿道前列腺电切术（transurethral resection of the prostate,TURP）联合小切口膀胱切开取石术,开放手术组采用耻骨上经膀胱前列腺切除联合取石术.观察两组患者的手术一般情况,比较两组患者术中、术后并发症和手术前后症状改善情况.结果 微创手术组患者的手术时间、术中出血量、膀胱冲洗时间和导尿管留置时间均较开放手术组少（P＜0.05）,两组患者前列腺切除质量无明显差别（P＞0.05）;微创手术组患者在术后1个月、3个月、6个月和12个月时IPSS、QOL得分较开放手术组降低,而Qmax得分较开放手术组显著升高（P＜O.05）;两组患者膀胱穿孔、直肠损伤和暂时性尿失禁等并发症发生率无明显差别（P＞0.05）.结论 微创治疗对BPH合并膀胱结石有较好的治疗效果,可明显改善患者不适,且安全性高.

Objective To observe the therapeutic effect of minimally invasive surgery on benign prostate hyperplasia （BPH） complicated with bladder stones.Methods A total of 88 patients with BPH complicated with bladder stones in our hospital from May 2014 to October 2015 were selected as object.According to the operation mode,all patients were divided into groups （50 cases） and open surgery group （38 cases）.Minimally invasive surgery group was treated by transurethral resection of the prostate （TURP） combined with small incision of the bladder stone,open surgery group underwent the pubic prostatectomy combined with transurethral resection of the prostate.Postoperative complications and symptoms before and after treatment between the two groups were compared.Results The operation time,amount of bleeding,bladder irrigation time and catheter indwelling time were less than that in the open surgery group,but there was no significant difference between the two groups.The QOL and IPSS scores at 1,3,6,12 months after operation in minimally invasive surgery group were lower than those of the open surgery group,while the Qmax score was significantly higher than the open surgery group （P ＜ 0.05）.There was no significant difference in the incidence of bladder perforation,rectal injury and temporary urinary incontinence between the two groups （P ＞ 0.05）.Conclusions Minimally invasive in the treatment of BPH with bladder stones has a good therapeutic effect,which can significantly improve the patient discomfort with high safety.