钬激光碎石术联合经尿道等离子电切术治疗前列腺增生症合并膀胱大结石的效果

Effect of holmium laser lithotripsy combined with transurethral plasma resection in the treatment of prostatic hyperplasia complicated with large bladder stones

目的探讨钬激光碎石术联合经尿道等离子电切术治疗前列腺增生症合并膀胱大结石的效果。方法选择本院2015年5月至2020年4月收治的46例前列腺增生症合并膀胱大结石患者为研究对象,根据随机数字表法将其分为对照组和观察组,各23例。对照组行开放取石术联合经尿道等离子电切术,观察组行钬激光碎石术联合经尿道等离子电切术。比较两组的治疗效果。结果观察组的术中出血量少于对照组,取石时间、手术耗时、术后膀胱冲洗时间、拔管时间及住院时间均短于对照组(P<0.05)。术后3个月,两组的最大尿流率、平均尿流率显著增大,残余尿量显著减少,且观察组优于对照组(P<0.05)。术后3个月,两组的IIEF-5评分及GQOLI-74各项评分均升高,IPSS评分均降低,且观察组优于对照组(P<0.05)。观察组的结石排净率明显高于对照组,并发症总发生率低于对照组(P<0.05)。结论采用钬激光碎石术联合经尿道等离子电切术治疗前列腺增生症合并膀胱大结石,能够优化围手术期指标,加速患者术后康复,改善其膀胱功能和生活质量。

Objective To explore the effect of holmium laser lithotripsy combined with transurethral plasma resection in the treatment of prostatic hyperplasia complicated with large bladder stones.Methods Forty-six patients with prostatic hyperplasia complicated with large bladder stones treated in our hospital from May 2015 to April 2020 were selected as the research objects and divided into control group and observation group according to the random number table method,with 23 cases in each group.The control group was treated with open lithotomy combined with transurethral plasma resection,and the observation group was treated with holmium laser lithotripsy combined with transurethral plasma resection.The therapeutic effects of the two groups were compared.Results The amount of intraoperative bleeding in the observation group was less than that in the control group,and the stone removal time,operation time,postoperative bladder flushing time,extubation time and hospital stay were shorter than those in the control group(P<0.05).Three months after operation,the maximum urinary flow rate and average urinary flow rate increased significantly and the residual urine volume decreased significantly in the two groups,and those in the observation group were better than the control group(P<0.05).Three months after operation,the IIEF-5 and GQOLI-74 scores of the two groups increased,the IPSS score decreased,and those of the observation group were better than the control group(P<0.05).The stone clearance rate in the observation group was significantly higher than that in the control group,while the total incidence of complications was lower than that in the control group(P<0.05).Conclusion Holmium laser lithotripsy combined with transurethral plasma resection in the treatment of prostatic hyperplasia complicated with large bladder stones can optimize perioperative indexes,accelerate postoperative rehabilitation of patients,and improve bladder function and quality of life.