同期腔内手术治疗老年输尿管中下段结石合并前列腺增生的有效性及安全性

Efficacy and safety of concurrent endoscopic surgery for middle and lower ureteral calculi complicated with benign prostatic hyperplasia in the elderly

目的探讨同期腔内手术治疗老年输尿管中下段结石合并前列腺增生的有效性及安全性.方法选取2018年2月至2019年5月在本院治疗的老年输尿管中下段结石合并前列腺增生患者126例,采用随机数字表法分为观察组和对照组,各63例.对照组采用分期腔内手术治疗,观察组采用同期腔内手术治疗.记录两组手术相关指标及术后并发症发生情况;观察两组术前(术前ld)及术后(术后2个月末)最大尿流率(Qmax)、残余尿量(RU)、前列腺症状评分(IPSS).结果观察组术中出血量少于对照组,手术时间、留置尿管时间、住院时间短于对照组(均P<0.05).术后,两组RU、IPSS评分均降低,Qmax升高,且观察组RU、IPSS评分低于对照组,Qmax水平高于对照组(均P<0.05).术后,观察组并发症总发生率低于对照组(11.11%比25.40%,P<0.05).结论同期腔内手术治疗老年输尿管中下段结石合并前列腺增生是一种有效的手术方式,具有创伤小、恢复快、安全性高等优点,且能减少术后并发症的发生,具有一定的临床应用价值.

Objective To explore the efficacy and safety of simultaneous endoscopic surgery for middle and lower ureteral calculi complicated with benign prostatic hyperplasia in the elderly.Methods 126 cases of middle-lower ureteral calculi and benign prostatic hyperplasia treated in our hospital from February,2018 to May,2019 were randomly divided into an observation group and a control group,with 63 cases in each group.The control group was treated by staged intracavitary surgery,while the observation group by simultaneous intracavitary surgery.The operation-related indicators and the occurrence of postoperative complications in the two groups were recorded and compared.The maximum urinary flow rates(Qmax),residual urine volumes(RU),and prostate symptom scores(IPSS)1 day before and 2 months after the operation were observed.Results The bleeding volume was lower and the operation time,indwelling time,and hospitalization time were shorter in the observation group than in the control group(all P<0.05).After the operation,the RU and IPSS scores decreased and the Qmax increased in both groups(all P<0.05);the RU and IPSS scores were lower and the Qmax was higher in the observation group than in the control group(all P<0.05).After the operation,the total incidence of complications was lower in the observation group than in the control group(11.11%vs.25.40%,P<0.05).Conclusion Endovascular surgery for middle and lower ureteral calculi complicated with benign prostatic hyperplasia in the elderly is an effective surgical method,which has the advantages of minimal trauma,rapid recovery,high safety,and can reduce the occurrence of postoperative complications.It has a certain clinical value.