经尿道前列腺等离子剜除术联合小切口治疗高龄高危良性前列腺增生合并膀胱结石的研究

Transurethral plasmakinetic enucleation and resection of prostate combined with mini-incision for senior and high-risk benign prostatic hyperplasia complicated with bladder stones

目的探讨经尿道前列腺等离子剜除术联合耻骨上小切口治疗高龄高危良性前列腺增生(BPH)合并膀胱结石的安全性及疗效。方法采用经尿道前列腺等离子剜除术联合耻骨上小切口治疗42例高龄高危BPH合并膀胱结石患者,比较术前及术后临床资料。结果该组患者均顺利完成,无死亡病例,手术时间(63.90±16.60)min,术中出血量(73.90±21.10)ml,无需要输血的病例,无1例发生前列腺电切综合征,术后未发现结石残留。手术前与手术后即刻生命特征及血K+、血清脑钠肽(BNP)等内环境指标比较差异无统计学意义,术中术后均无严重内科并发症发生。术后随访3个月,最大尿流率(Qmax)、残余尿(PVR)、国际前列腺症状评分(IPSS)和生活质量评分(QOL)与术前比较,差异均有统计学意义(P<0.05)。结论经尿道前列腺剜除术联合小切口切开取石并取出剜除腺瘤的手术方式治疗高龄高危BPH患者伴膀胱结石,安全性好,疗效确切,特别适用于高龄高危的患者。

Objective To investigate the clinical safety and effect of transurethral plasmakinetic enucleation and resection of prostate combined with mini-incision in the treatment of senior and high-risk benign prostatic hyperplasia(BPH)with bladder stones.Methods Clinical data of42patients of senior and high-risk benign prostatic hyperplasia(BPH)with bladder stones was analyzed.All patients were treated with transurethral plasmakinetic enucleation and resection of prostate combined with mini-incision cystofithotomy.Results All operations were successfully performed without deaths.The operative time was52~86min,mean(63.90±16.60)min.The blood loss was45.0~136.0ml,mean(73.90±21.10)ml.There were no significant differences in the immediate life characteristics,serum K+,serum brain natriuretic peptide and other internal environmental indexes before and after operation.There were no serious complications in perioperation.3months after operation,international prostate symptomscore(IPSS),quality of life score(QOL),the maximum flow rate(Qmax)improved significantly compared with preoperation,significantly reduced the post void residual volume(PVR).Conclusion Transurethral plasmakinetic enucleation and resection of prostate combined with mini-incision can be particularly applied to elderly patients with high risk BPH complicated with bladder stones with efficaciously and more safety.