经尿道前列腺切除术联合腔内气压弹道碎石治疗前列腺增生合并膀胱结石患者的效果观察

Effect of Transurethral Prostatectomy Combined with Pneumatic Lithotripsy in the Treatment of Patients with Prostatic Hyperplasia Complicated with Bladder Stones

目的:探讨经尿道前列腺切除术联合腔内气压弹道碎石对前列腺增生合并膀胱结石的治疗效果。方法:选取2016年10月—2018年10月永州市中心医院收治的96例前列腺增生合并膀胱结石患者作为研究对象,均行经尿道前列腺切除术,随机分为对照组和观察组,每组各48例。对照组行经尿道前列腺电切术联合耻骨小切口切开取石术,观察组行经尿道前列腺切除术联合气道弹压碎石术。比较两组患者临床疗效、手术情况、尿动力学、前列腺功能、并发症发生率和生活质量。结果:观察组总有效率高于对照组,术中出血量少于对照组,置管时间、冲洗膀胱时间和住院时间短于对照组,差异有统计学意义(χ^(2)=6.400,t=4.799、13.348、15.472、13.236,P<0.05);两组患者术前自由尿流率、残余尿量和国际前列腺症状评分(IPSS)一致,观察组术后自由尿流率和生活质量高于对照组,残余尿量和IPSS评分低于对照组,差异有统计学意义(t=7.993、17.471、20.911,P<0.05)。与对照组比较,观察组并发症的概率更低,术后生活质量各项得分更高,差异有统计学意义(χ^(2)=4.413,t=5.063、6.393、5.463、6.276、4.516,P<0.05)。结论:在前列腺增生合并膀胱结石的治疗中应用经尿道前列腺切除术联合腔内气压弹道碎石术,术后恢复快,可改善尿动力学和前列腺功能,术后并发症少,利于提高患者生活质量。

Objective: To investigate the therapeutic effect of transurethral prostatectomy plus intraluminal pneumatic lithotripsy in the treatment of prostatic hyperplasia complicated with bladder stones. Methods: A total of 96 patients with benign prostatic hyperplasia combined with bladder stones who were admitted to the hospital from October 2016 to October 2018 were selected, all underwent transurethral resection of the prostate, and were randomly divided into the control group and the observation group, with 48 cases in each group. The control group underwent transurethral resection of the prostate combined with small pubic incision lithotripsy, while the observation group underwent transurethral resection of the prostate combined with airway lithotripsy.The clinical efficacy, surgical conditions, urodynamics, prostate function, incidence of complications and quality of life were compared between the two groups. Results: The total effective rate of the observation group was higher than that of the control group, the intraoperative blood loss was less than that of the control group, the catheterization time, bladder flushing time and hospitalization time were shorter than those of the control group, and the incidence of complications was lower than that of the control group, and the differences were statistically significant(χ2=6.400, t=4.799, 13.348, 15.472, 13.236, P<0.05). The preoperative free urine flow rate, residual urine volume and IPSS score of the two groups were the same. The postoperative free urine flow rate and quality of life in the observation group were higher than those in the control group, and the residual urine volume and IPSS score were lower than those in the control group, and the differences were statistically significant(t=7.993,17.471, 20.911, P<0.05). Compared with the control group, the observation group had a lower probability of complications and higher scores of postoperative quality of life, and the difference was statistically significant(χ2=4.413, t=5.063, 6.393, 5.463, 6.276,4.516, P<0.05). Conclusion: Transurethral resection of prostate combined with intracavitary pneumatic lithotripsy is applied in the treatment of benign prostatic hyperplasia combined with bladder calculi. The effect is good, the postoperative recovery is fast,urodynamics and prostate function can be improved, and postoperative complications are less, which is conducive to improving the patients’ quality of Life.