两种手术联合治疗良性前列腺增生并膀胱结石的效果评价

Efficacy Evaluation of Two Surgical Treatments for Benign Prostatic Hyperplasia Complicated with Bladder Calculus

目的:通过观察良性前列腺增生并膀胱结石患者经治疗后的临床表现,探讨经皮肾镜气压弹道碎石联合前列腺电切术对该种病症的治疗效果。方法:选取2009年7月-2016年12月在本院接受治疗的良性前列腺增生并膀胱结石患者90例,根据治疗方式的不同将其分为观察组和对照组,每组各45例。观察组采用经皮肾镜气压弹道碎石联合前列腺电切术治疗,对照组采用常规手术治疗。观察并记录两组患者相关的临床指标数据,包括治疗总有效率、手术时间和住院时间、国际前列腺症状(IPSS)评分、导尿管的留置时间和术中出血量、最大尿流率和残余尿量等,并进行统计分析。结果:观察组的治疗总有效为44例(97.78%),优于对照组的42例(93.33%),但比较差异无统计学意义(P>0.05);两组患者取石时间和手术时间比较,差异无统计学意义(P>0.05);观察组患者术中出血量、导尿管留置时间、住院时间均少于对照组(P<0.05);治疗后两组患者的最大尿流率较治疗前明显上升,IPSS评分和残余尿量均较治疗前明显下降,比较差异均有统计学意义(P<0.05);治疗后两组患者IPSS评分和残余尿量比较,差异均无统计学意义(P>0.05);观察组患者最大尿流率较对照组明显上升(P<0.05)。结论:采用经皮肾镜气压弹道碎石联合前列腺电切术治疗良性前列腺增生并膀胱结石疗效显著,能够显著减少术中出血量和住院时间,有效推进患者的术后恢复进程,使患者的临床症状在很大程度上得到改善,生活质量由此显著提高,值得在临床上进行推广应用。

Objective:To observe the clinical manifestations of benign prostatic hyperplasia complicated with bladder calculus after treatment,to investigate the efficacy of percutaneous nephrolithotomy combined with transurethral resection of the prostate in treatment of this disease.Method:90 cases of benign prostatic hyperplasia complicated with bladder calculus treated in our hospital from July 2009 to December 2016 were selected,they were divided into observation group and control group according to the different treatment methods,45 cases in each group.The observation group was treated with percutaneous nephrolithotomy pneumatic lithotripsy combined with transurethral resection of prostate,and control group was treated with routine surgery.The clinical data of two groups were observed and recorded,included clinical efficacy,operation time,length of hospital stay,intraoperative blood loss,catheter retention time,treatment time,international prostate symptom score,maximum urinary flow rate,residual urine volume and so on.Result:The total effective rate of observation group was 97.78%,which was better than that 93.33%of control group,but the difference was not statistically significant(P>0.05).The operation time and calculus removal time of two groups were compared,the difference was not statistically significant(P>0.05).The amount of bleeding during operation,indwelling time of catheter and length of hospital stay in observation group were less than those of control group(P<0.05).After treatment,the maximum urinary flow rate of two groups was significantly higher than that of before treatment,and the IPSS score and residual urine volume were significantly lower than those of before treatment,the differences were statistically significant(P<0.05);the IPSS score and residual urine volume of two groups were compared after treatment,the differences were not statistically significant(P>0.05);the maximum urinary flow rate of observation group was significantly higher than that of control group(P<0.05).Conclusion:Percutaneous nephrolithotomy pneumatic lithotripsy combined with transurethral resection of prostate in treatment of benign prostatic hyperplasia complicated with bladder calculus has significant curative effect,can significantly reduce intraoperative blood loss and hospital stay,effectively shorten the patients’postoperative recovery process,making the patients’clinical symptoms to a large extent improved,quality of life has been significantly improved,worthy of clinical application in the promotion.