经尿道前列腺等离子电切联合钬激光碎石术治疗良性前列腺增生伴膀胱结石的疗效分析

Efficacy Analysis of Transurethral Prostate Plasma Combined With Holmium Laser Lithotripsy for the Treatment of Benign Prostatic Hyperplasia With Bladder Stones

目的观察经尿道前列腺等离子电切(TUPKP)联合钬激光碎石术治疗良性前列腺增生(BPH)伴膀胱结石的临床疗效。方法选取2012年6月~2017年6月期间在我院泌尿外科接受手术治疗的BPH伴膀胱结石患者,根据患者手术方式分为观察组和对照组各40例。对照组行弹道碎石联合TUPKP,观察组行钬激光碎石联合TUPKP。对比两组患者的术中情况以及术前、术后国际前列腺症状评分(IPSS评分)、最大尿流率(Qmax)、残余尿量(RUV)及并发症发生率。结果观察组患者的手术时间及术中出血量较对照组少(P<0.05);观察组患者的住院时间、手术时间及导尿管留置时间均较对照组短,差异有统计学意义(P<0.05);两组患者术后的IPSS评分、Qmax及RUV较术前均有统计学差异(P<0.05);观察组结石残留、结石复发及尿道狭窄等并发症的发生率较对照组低(P<0.05)。结论钬激光碎石术联合前列腺等离子电切术治疗BPH伴膀胱结石,能有效减少术中出血量,缩短住院时间、导尿管留置时间,降低术后泌尿系统感染率,可在一定程度上降低老年患者的手术风险,因此值得临床推广运用。

Objective To observe the clinical efficacy of TUPKP combined with holnfium laser lithotripsy in the treatment of BPH with bladder stones.Methods Analyse retrospectively 80 cases of BPH patients with bladder stones undergoing surgery in our department of urology during June 2012 to June 2017,according to the patients＇ surgical methods,40 patients are divided into each group（control group and observation group）.control Group：Ballistic lithotripsy combined with TUPKP,observation group：TUPKP combined with holmium laser lithotripsy.Compare the intraoperative conditions and the preoperative and postoperative international prostate symptom scores（IPSS scores）,maximum urinary flow rate（Qmax）, residual urine volume（RUV）, and incidence of complications between the two groups of patients.Results The operation time and intraoperative blood loss of observation group patients are less than that of control group（P〈0.05）. The hospitalization time, operation time and catheter indwelling time of observation group patients are shorter than those of control group, and the difference is statistically significant（P〈0.05）. All patients had statistically significant differences in postoperative IPSS scores, Qmax, and RUV（P〈0.05）.The incidence of complications such as residual stones, recmTence of stones, and urethral stricture are lower in observation group than in control group （P〈0.05）.Conclusion Holmium laser lithotripsy combined with TUPKP in the treatment of BPH with bladder stones can effectively reduce the amount of intraoperative blood loss, shorten the hospitalization time, catheter indwelling time, reduce postoperative urinary tract infection rate, and can reduce the surgical risk of elderly patients to a certain extent Therefore, it is worthy of clinical application.