经尿道前列腺汽化电切术联合钬激光碎石术治疗BPH合并膀胱结石的疗效
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摘要
目的探讨经尿道前列腺汽化电切术联合钬激光碎石术同期治疗良性前列腺增生(BPH)合并膀胱结石的临床效果。方法选择2013年2月至2016年8月该院泌尿外科收治的BPH合并膀胱结石手术治疗的286例患者,按照随机数字表法分为对照组和观察组,每组143例。对照组采用经尿道前列腺汽化电切术联合气压弹道碎石术,观察组采用经尿道前列腺汽化电切术联合钬激光碎石术,对两组治疗的效果进行分析和评价。结果治疗前后两组患者的国际前列腺症状评分、最大尿流速、残余尿量比较,差异均有统计学意义(P>0.05),观察组国际前列腺症状评分和残余尿量低于对照组,最大尿流速高于对照组,差异均有统计学意义(P>0.05)。对照组部分患者术后出现了泌尿系感染、结石残留、尿道狭窄和结石复发,而观察组无患者出现以上并发症,两组患者不良反应发生率比较,差异均有统计学意义(P<0.05)。结论经尿道前列腺汽化电切术联合钬激光碎石术治疗BPH合并膀胱结石患者,可以提高疗效,减少并发症的发生,取得了满意的临床疗效,是值得推广的一种治疗方法。
Objective To explore the clinical effect of transurethral electrovaporization of the prostate(TUVP)combined with holmium laser lithotripsy in the treatment of benign prostatic hyperplasia(BPH)complicating bladder calculi.Methods A total of 286 patients with BPH complicating bladder stones in the urological surgery department of this hospital from February 2013 to August 2016 were selected and divided into the control group and observation group according to the random number table method,143 cases in each group.The control methods adopted TUVP combined with pneumatic lithotripsy,while the observation group adopted the TUVP combined with holmium laser lithotripsy.Then the treatment effects in the two groups were analyzed and evaluated.Results The international prostate symptom score,maximal urinary flow rate and residual urine volume before and after treatment had statistical differences between the two groups(P>0.05).Some parents in the international prostate symptom score and residual urine volume in the observation group were lower than those in the control group,while the maximal urinary flow rate was higher than that in the control group,the differences were statistically significant(P<0.05).The control group appeared the urinary tract infection,retained stones,urethral stricture and recurrence of stones,but no above complications occurred in the observation group,the difference on the complication rates between the two groups was statistically significant(P<0.05).Conclusion TUVP combined with holmium laser lithotripsy in the treatment of BPH complicating bladder stones can improve the curative efficacy,reduces the appearance of complications,achieves satisfactory clinical efficacy,and is a treatment method worth promotion.
Objective To explore the clinical effect of transurethral electrovaporization of the prostate(TUVP)combined with holmium laser lithotripsy in the treatment of benign prostatic hyperplasia(BPH)complicating bladder calculi.Methods A total of 286 patients with BPH complicating bladder stones in the urological surgery department of this hospital from February 2013 to August 2016 were selected and divided into the control group and observation group according to the random number table method,143 cases in each group.The control methods adopted TUVP combined with pneumatic lithotripsy,while the observation group adopted the TUVP combined with holmium laser lithotripsy.Then the treatment effects in the two groups were analyzed and evaluated.Results The international prostate symptom score,maximal urinary flow rate and residual urine volume before and after treatment had statistical differences between the two groups(P>0.05).Some parents in the international prostate symptom score and residual urine volume in the observation group were lower than those in the control group,while the maximal urinary flow rate was higher than that in the control group,the differences were statistically significant(P<0.05).The control group appeared the urinary tract infection,retained stones,urethral stricture and recurrence of stones,but no above complications occurred in the observation group,the difference on the complication rates between the two groups was statistically significant(P<0.05).Conclusion TUVP combined with holmium laser lithotripsy in the treatment of BPH complicating bladder stones can improve the curative efficacy,reduces the appearance of complications,achieves satisfactory clinical efficacy,and is a treatment method worth promotion.
引文
[1]刘龙,旷建刚.经尿道前列腺汽化电切术联合钬激光碎石术同期治疗良性前列腺增生症合并膀胱结石的临床效果[J].中国医药导报,2016,13(27):95-98.
[2]吴永兵,宋体松,葛玉峰,等.两种不同手术方式治疗前列腺增生合并膀胱结石的临床研究[J].微创医学,2015,10(6):827-829.
[3]黄健云,吴晓波,向克明.腔内技术治疗前列腺增生合并膀胱结石的临床观察[J].中国医药指南,2010,8(13):125-126.
[4]钱佳琦,刘继新,李红蕾,等.2微米激光联合小切口治疗高危前列腺增生合并膀胱结石的临床研究[J].河北医学,2014,20(8):1322-1324.
[5]梁学清,于兵,李丹丹,等.经尿道前列腺汽化电切术联合钬激光碎石术同期治疗良性前列腺增生症合并膀胱结石的临床疗效[J].中国老年学杂志,2016,36(1):146-147.
[6]ZHAO J,SHI L,GAO Z,et al.Minimally invasive surgery for patients with bulky bladder stones and large benign prostatic hyperplasia simultaneously:a novel design[J].Urol Int,2013,91(1):31-37.
[7]杨琛.腔内治疗前列腺增生合并膀胱结石40例[J].中国医药指南,2016,14(28):122.
[8]陈海,韩友峰,张正,等.良性前列腺增生合并膀胱结石的治疗[J].中国激光医学杂志,2016,25(5):299.
[9]刘险峰.经尿道手术治疗前列腺增生症合并膀胱结石的临床效果[J].中国医药指南,2016,14(34):119-120.
[10]郁兆存,黄华生,陈早庆,等.不同手术方法治疗老年前列腺增生合并膀胱结石效果及对患者性功能的影响[J].中国性科学,2017,26(4):10-13.
[11]简毓,吴曦,张鹏,等.输尿管镜下钬激光联合封堵器碎石术与传统钬激光碎石术治疗输尿管结石临床研究[J].海南医学,2017,28(6):904-906.
[12]张建荣,郭军,杨杨,等.输尿管镜下钬激光碎石术治疗输尿管结石的临床疗效[J].中国医药指南,2017,15(9):158-159.
[13]吴序立,郑培奎,黄伟雄.双极等离子电切联合经皮膀胱通道钬激光碎石治疗高龄高危前列腺增生合并膀胱结石[J].中国微创外科杂志,2015,21(4):332-335.
[14]TAN Y K,GUPTA D M,WEINBERG A,et al.Minimally invasive percutaneous management of large bladder stones with a laparoscopic entrapment bag[J].J Endourol,2014,28(1):61-64.
[15]吴德尧,潘慧星.输尿管镜下钬激光碎石术与腹腔镜手术治疗输尿管结石的疗效[J].江苏医药,2017,43(9):644-647.
[2]吴永兵,宋体松,葛玉峰,等.两种不同手术方式治疗前列腺增生合并膀胱结石的临床研究[J].微创医学,2015,10(6):827-829.
[3]黄健云,吴晓波,向克明.腔内技术治疗前列腺增生合并膀胱结石的临床观察[J].中国医药指南,2010,8(13):125-126.
[4]钱佳琦,刘继新,李红蕾,等.2微米激光联合小切口治疗高危前列腺增生合并膀胱结石的临床研究[J].河北医学,2014,20(8):1322-1324.
[5]梁学清,于兵,李丹丹,等.经尿道前列腺汽化电切术联合钬激光碎石术同期治疗良性前列腺增生症合并膀胱结石的临床疗效[J].中国老年学杂志,2016,36(1):146-147.
[6]ZHAO J,SHI L,GAO Z,et al.Minimally invasive surgery for patients with bulky bladder stones and large benign prostatic hyperplasia simultaneously:a novel design[J].Urol Int,2013,91(1):31-37.
[7]杨琛.腔内治疗前列腺增生合并膀胱结石40例[J].中国医药指南,2016,14(28):122.
[8]陈海,韩友峰,张正,等.良性前列腺增生合并膀胱结石的治疗[J].中国激光医学杂志,2016,25(5):299.
[9]刘险峰.经尿道手术治疗前列腺增生症合并膀胱结石的临床效果[J].中国医药指南,2016,14(34):119-120.
[10]郁兆存,黄华生,陈早庆,等.不同手术方法治疗老年前列腺增生合并膀胱结石效果及对患者性功能的影响[J].中国性科学,2017,26(4):10-13.
[11]简毓,吴曦,张鹏,等.输尿管镜下钬激光联合封堵器碎石术与传统钬激光碎石术治疗输尿管结石临床研究[J].海南医学,2017,28(6):904-906.
[12]张建荣,郭军,杨杨,等.输尿管镜下钬激光碎石术治疗输尿管结石的临床疗效[J].中国医药指南,2017,15(9):158-159.
[13]吴序立,郑培奎,黄伟雄.双极等离子电切联合经皮膀胱通道钬激光碎石治疗高龄高危前列腺增生合并膀胱结石[J].中国微创外科杂志,2015,21(4):332-335.
[14]TAN Y K,GUPTA D M,WEINBERG A,et al.Minimally invasive percutaneous management of large bladder stones with a laparoscopic entrapment bag[J].J Endourol,2014,28(1):61-64.
[15]吴德尧,潘慧星.输尿管镜下钬激光碎石术与腹腔镜手术治疗输尿管结石的疗效[J].江苏医药,2017,43(9):644-647.