经尿道等离子前列腺剜除术治疗前列腺增生合并膀胱结石的疗效

Effect of transurethral plasma enucleation of prostate on benign prostatic hyperplasia with bladder stones

目的:探究经尿道等离子前列腺剜除术(PKEP)在治疗良性前列腺增生(BPH)合并膀胱结石中的疗效。方法:选择在医院就诊的169例BPH合并膀胱结石患者,研究组89例患者接受PKEP加经尿道钬激光碎石术治疗,对照组80例患者接受前列腺等离子电切术(PKRP)治疗,对比两组患者围术期创伤指标、围术期并发症发生率、前列腺影像学指标、前列腺症状评分、生活质量评分差异。结果:研究组患者手术时间长于对照组,但术中出血量、止痛药应用次数及住院时间均低于对照组(P<0.05);研究组患者并发症总发生率略低于对照组,但差异无统计学意义(P>0.05);手术后,两组患者的前列腺体积缩小、残余尿量(PVR)降低、最大尿流率(Qmax)升高(P<0.05),且研究组患者前列腺体积及PVR高于对照组,Qmax低于对照组(P<0.05);手术后,两组患者的前列腺症状评分及生活质量评分均降低,且研究组更低(P<0.05)。结论:PKEP加经尿道钬激光碎石术治疗BPH合并膀胱结石能够明显降低对患者手术创伤,改善患者前列腺指标及生活质量,具有较好的推广价值。

Objective:To investigate the efficacy of transurethral plasma enucleation of the prostate in the treatment of benign prostatic hyperplasia with bladder stones.Methods:The 169 BPH patients with bladder stones presenting to our hospital were divided into two groups,the study group received PKEP plus transurethral holmium laser lithotripsis(n=89),and the control group received plasmotomy of prostate(PKRP)(n=80).The perioperative trauma index,perioperative complication rate,prostate imaging index,prostate symptom score and quality of life score were compared between the two groups.Results:The operation time was longer in the study group,but the intraoperative blood loss,the number of painkiller application and the length of hospital stay were lower(P<0.05).The total complication rate of the study group which was significantly lower,but the difference was not significant(P>0.05).After surgery,prostate volume and PVR were decreased in both groups,while Qmax was increased(P<0.05).The prostate volume and PVR of the study group were higher,while Qmax was lower.After surgery,prostate symptom scores and quality of life scores were lower in both groups,and lower in the study group(P<0.05).Conclusion:PKEP combined with transurethral holmium laser lithotripsy in the treatment of BPH associated with bladder calculi can significantly reduce the incidence of surgical trauma and perioperative complications,improve the prostate index and quality of life of patients,and has a good promotion value.