前列腺电切联合激光碎石治疗前列腺增生合并膀胱结石的有效性

Efficacy of Prostatectomy Combined With Laser Lithotripsy in the Treatment of Benign Prostatic Hyperplasia and Bladder Stones

目的 分析经尿道前列腺汽化电切术(transurethral vaporization of prostate,TUVP)在临床上联合钬激光碎石术治疗良性前列腺增生症(benign prostatic hyperplasia,BPH)合并有膀胱结石患者的临床疗效及安全性。方法 选取2019年1月—2021年1月在龙岩市第二医院住院并接受手术治疗的良性前列腺增生合并膀胱结石患者85例作为研究对象,对其临床资料进行回顾性研究分析。结果 作为研究对象的85例患者均完成手术,且手术过程顺利。平均电切时间为(62.65±11.28)min,平均碎石时间为(15.58±6.12)min,平均取石时间为(8.58±3.12)min。术中、术后均未出现大出血、电切综合征(transurethral resection syndrome,TUR-S)、结石残留、尿道狭窄等并发症。术后对患者进行3~27个月的随访,其间患者膀胱结石均未复发。末次随访时,患者国际前列腺症状评分(International prostate symptom score,IPSS)、生存质量评分(quality of life,QOL)、最大尿流量(maximum flow rate,Qmax)情况以及残余尿量(residual urine volume,RUV)结果均较术前明显改善,其差异有统计学意义(P <0.05)。结论临床上使用经尿道前列腺汽化电切术(TUVP)联合钬激光碎石取石术治疗BPH合并膀胱结石患者,创伤小、操作简便、碎石取石效率高、并发症少,患者生存质量高,效果值得肯定。

Objective To analyze the clinical efficacy and safety of transurethral vaporization of prostate(TUVP) combined with holmium laser lithotripsy in the treatment of benign prostatic hyperplasia(BPH) with bladder stones.Methods A total of 85patients with benign prostatic hyperplasia complicated with bladder stones who were hospitalized and underwent surgical treatment in The Second Hospital of Longyan from January 2019 to January 2021 were selected as the research objects for retrospective study and analysis of their clinical data.Results All 85 patients as the research objects completed the procedure successfully.The average electrocision time was(62.65±11.28) min,the average lithotripsy time was(15.58±6.12) min,and the average time of stone extraction was(8.58±3.12) min.No intraoperative and postoperative complications such as massive hemorrhage,transurethral resection syndrome(TUR-S),residual stones,urethral stricture,etc.occurred.All patients were followed up for 3-27 months,during which no recurrence of bladder calculi was found.At the last follow-up,the results of International prostate symptom score(IPSS),quality of life(QOL),maximum flow rate(Qmax) and residual urine volume(RUV)were significantly improved compared with preoperative results,and the differences were statistically significant(P < 0.05).Conclusion The clinical use of transurethral vaporization of prostate(TUVP) combined with holmium laser lithotripsy in the treatment of BPH patients with bladder stones has the advantages of less trauma,simple operation,high lithotripsy removal efciency,fewer complications and high quality of life.The effect is worthy of afrmation.