两种手术方式联合治疗前列腺增生并膀胱结石的效果观察

Observation on the Effect of Two Surgical Methods in the Treatment of Benign Prostatic Hyperplasia and Bladder Stones

目的分析气压弹道碎石术(PL)联合等离子电切术(PKRP)、经尿道钬激光碎石术(HLL)联合PKRP两种手术联合方案治疗前列腺增生(PH)并膀胱结石的临床效果。方法选取2020年7月-2022年3月都昌县人民医院收治的60例BPH并膀胱结石患者,采用随机数字表法分为对照组(30例)和观察组(30例)。对照组采用PL联合PKRP治疗,观察组应用HLL联合PKRP治疗,比较两组手术指标(手术时间、术中出血量、取石时间、住院时间、留置导管时间)、治疗效果、国际前列腺症状量表(IPSS)评分、生活质量量表(QOL)评分、术后并发症。结果观察组手术时间、取石时间、留置导管时间、住院时间均短于对照组,且术中出血量少于对照组(P<0.05);观察组治疗总有效率高于对照组(P<0.05);观察组术后3个月IPSS评分低于对照组,QOL评分高于对照组(P<0.05);观察组术后并发症发生率低于对照组(P<0.05)。结论HLL联合PKRP治疗PH并膀胱结石效果显著,其手术时间短、术中出血少、术后恢复快,可有效缓解患者的前列腺症状,改善其生活质量,且安全性高,整体应用效果优于PL联合PKRP。

Objective To analyze the clinical effects of pneumatic lithotripsy(PL)combined with plasma kinetic resection of prostate(PKRP)and transurethral holmium laser lithotripsy(HLL)combined with PKRP in the treatment of prostatic hyperplasia(PH)and bladder stones.Methods Sixty patients with PH and bladder calculi admitted to Duchang County People's Hospital from July 2020 to March 2022 were selected and divided into control group(30 cases)and observation group(30 cases)by random number table method.The control group was treated with PL combined with PKRP,and the observation group was treated with HLL combined with PKRP.The operation indexes(operation time,intraoperative blood loss,stone removal time,hospitalization time,indwelling catheter time),treatment effect,international prostate symptom scale(IPSS)score,quality of life scale(QOL)score,postoperative complications were compared between the two groups.Results The operation time,stone removal time,indwelling catheter time and hospitalization time in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group(P<0.05).The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).The IPSS score of the observation group was lower than that of the control group at 3 months after operation,and the QOL score was higher than that of the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion HLL combined with PKRP is effective in the treatment of PH and bladder stones.It has the advantages of short operation time,less intraoperative bleeding and rapid postoperative recovery.Meanwhile,it can effectively relieve the symptoms of prostate,improve the quality of life,with high safety.The overall application effect is better than that of PL combined with PKRP.