经皮肾镜钬激光碎石联合前列腺电切术治疗良性前列腺增生伴发膀胱结石的临床效果观察
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摘要
目的观察经皮肾镜钬激光碎石联合前列腺电切术治疗良性前列腺增生(BPH)伴发膀胱结石的疗效及对患者围术期指标、并发症的影响。方法我院收治的64例BPH伴发膀胱结石患者,按照入院单双号顺序分为两组各32例,A组使用经皮肾镜钬激光碎石联合前列腺电切术,B组采取耻骨上前列腺切除术及膀胱切开取石术,比较两组手术前后前列腺症状(IPSS)评分、生活质量(QOL)评分、残余尿量,并观察两组手术指标、术后恢复情况、并发症发生率。结果 A组术中出血量及术后并发症总发生率低于B组,术后导管留置时间及住院时间短于B组(P <0. 05);术后3个月,A组IPSS评分、QOL评分低于B组,残余尿量少于B组(P <0. 05);两组取石时间、手术时间、术后膀胱冲洗时间比较差异无统计学意义(P> 0. 05)。结论经皮肾镜钬激光碎石联合前列腺电切术可有效治疗BPH伴发膀胱结石,术中出血量少,患者术后恢复快,并发症少。
Objective To observe the curative effect of percutaneous nephrolithotripsy by using holmium laser combined with prostate electrocision in the treatment of benign prostatic hyperplasia( BPH) with bladder calculi and the influence of the treatments on perioperative indexes and complications.Methods Sixty-four patients with BPH and bladder calculi in our hospital were divided into A and B groups according to the order of admission,32 in each group.The group A was treated with percutaneous nephrolithotripsy by using holmium laser combined with prostate electrocision while the group B was treated with suprapubic prostatectomy and cystolithectomy.The prostate symptoms( IPSS) score,quality of life( QOL) score,and residual urine volume before and after surgery were compared between the two groups.The surgical indexes,postoperative conditions and complication rate of the two groups were also observed.Results The intraoperative blood loss,total incidence of postoperative complications,time of catheter indwelling and hospitalization time in the group A were less or lower or shorter than those in the group B( P < 0. 05).After 3 months of surgery,the scores of IPSS and QOL and the residual urine volume in the group A were significantly lower than those in group B( P < 0. 05).There was no significant difference in stone removal time,operation time and postoperative bladder irrigation time between the two groups( P >0. 05).Conclusion Percutaneous nephrolithotripsy by using holmium laser combined with prostate electrocision can effectively treat BPH combined with bladder calculi.The intraoperative blood loss is little.The patients' recovery is quick with fewer complications.
Objective To observe the curative effect of percutaneous nephrolithotripsy by using holmium laser combined with prostate electrocision in the treatment of benign prostatic hyperplasia( BPH) with bladder calculi and the influence of the treatments on perioperative indexes and complications.Methods Sixty-four patients with BPH and bladder calculi in our hospital were divided into A and B groups according to the order of admission,32 in each group.The group A was treated with percutaneous nephrolithotripsy by using holmium laser combined with prostate electrocision while the group B was treated with suprapubic prostatectomy and cystolithectomy.The prostate symptoms( IPSS) score,quality of life( QOL) score,and residual urine volume before and after surgery were compared between the two groups.The surgical indexes,postoperative conditions and complication rate of the two groups were also observed.Results The intraoperative blood loss,total incidence of postoperative complications,time of catheter indwelling and hospitalization time in the group A were less or lower or shorter than those in the group B( P < 0. 05).After 3 months of surgery,the scores of IPSS and QOL and the residual urine volume in the group A were significantly lower than those in group B( P < 0. 05).There was no significant difference in stone removal time,operation time and postoperative bladder irrigation time between the two groups( P >0. 05).Conclusion Percutaneous nephrolithotripsy by using holmium laser combined with prostate electrocision can effectively treat BPH combined with bladder calculi.The intraoperative blood loss is little.The patients' recovery is quick with fewer complications.
引文
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[5]代庆德,段晓波,刘华伟,等.前列腺增生合并膀胱结石的微创治疗效果分析[J].国际泌尿系统杂志,2017,37(5):674-677.
[6]Dai X,Fang X,Ma Y,et al. Benign Prostatic Hyperplasia and the Risk of Prostate Cancer and Bladder Cancer:A Meta-Analysis of Observational Studies[J].Medicine,2016,95(18):e3493.
[7]Bhattar R,Yadav SS,Tomar V,et al.Role of oestrogen receptor-αand-βin bladder tissue of patients with a clinical diagnosis of benign prostatic hyperplasia[J].Bju International,2018,121(1):130-138.
[8]张广涛,史学珍,高敬峰,等.两种不同碎石方法联合尿道电切镜治疗前列腺增生并膀胱结石的效果比较[J].宁夏医科大学学报,2017,39(2):222-224.
[9]张金华.不同手术方法治疗前列腺增生合并膀胱结石的对比研究[J].国际泌尿系统杂志,2016,36(3):337-340.
[10]李建友,陈鑫,王胜,等.经尿道前列腺电气化术联合钬激光碎石术治疗前列腺增生合并膀胱结石临床研究[J].中国性科学,2017,26(5):27-29.
[11]植凡,李先承,梁辉.良性前列腺增生伴发膀胱结石不同治疗方法的临床效果研究[J].实用药物与临床,2016,19(2):204-207.
[2]Bhattar R,Yadav SS,Tomar V,et al.Role of estrogen receptor alpha and beta in bladder tissue in patients with clinical diagnosis of benign prostatic hyperplasia[J]. Bju International,2017,121(Suppl9):130-138.
[3]Silvaramos M,Silva I,Oliveira J C,et al.Increased urinary adenosine triphosphate in patients with bladder outlet obstruction due to benign prostate hyperplasia[J].Prostate,2016,76(15):1353-1363.
[4]金涛,骆竹媚,邓实,等.改良后等离子电切镜鞘联合钬激光治疗39例膀胱结石的疗效分析[J].成都医学院学报,2016,11(6):669-671.
[5]代庆德,段晓波,刘华伟,等.前列腺增生合并膀胱结石的微创治疗效果分析[J].国际泌尿系统杂志,2017,37(5):674-677.
[6]Dai X,Fang X,Ma Y,et al. Benign Prostatic Hyperplasia and the Risk of Prostate Cancer and Bladder Cancer:A Meta-Analysis of Observational Studies[J].Medicine,2016,95(18):e3493.
[7]Bhattar R,Yadav SS,Tomar V,et al.Role of oestrogen receptor-αand-βin bladder tissue of patients with a clinical diagnosis of benign prostatic hyperplasia[J].Bju International,2018,121(1):130-138.
[8]张广涛,史学珍,高敬峰,等.两种不同碎石方法联合尿道电切镜治疗前列腺增生并膀胱结石的效果比较[J].宁夏医科大学学报,2017,39(2):222-224.
[9]张金华.不同手术方法治疗前列腺增生合并膀胱结石的对比研究[J].国际泌尿系统杂志,2016,36(3):337-340.
[10]李建友,陈鑫,王胜,等.经尿道前列腺电气化术联合钬激光碎石术治疗前列腺增生合并膀胱结石临床研究[J].中国性科学,2017,26(5):27-29.
[11]植凡,李先承,梁辉.良性前列腺增生伴发膀胱结石不同治疗方法的临床效果研究[J].实用药物与临床,2016,19(2):204-207.