双极等离子电切联合下腹部小切口治疗前列腺增生症并发巨大膀胱结石34例
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摘要
目的探讨治疗前列腺增生症(BPH)并发巨大膀胱结石的有效方法。方法回顾分析34例采用经尿道等离子前列腺电切(TPKRP)联合下腹部小切口膀胱切开取石术治疗BPH并发巨大膀胱结石的临床资料。结果全组34例均顺利完成手术,等离子前列腺电切50~108 min,平均72 min。耻骨上膀胱切开取石20~45 min,平均38 min。术中出血量约150~250 ml,平均215 ml,未出现严重并发症病例。随访2~24个月,术后国际前列腺症状评分(IPSS)平均6.6分,生活质量评分(QOL)平均1.8分,平均尿流率(AFR)13.8 ml/s。结论双极等离子电切联合下腹部小切口治疗BPH并发巨大膀胱结石是一种安全、高效、低费用的术式,适合基层医院推广应用。
Objective To explore the effective methods to treat benign prostatic hyperplasia( BPH) patients with huge bladder stones. Methods The data of 34 BPH patients with huge bladder stone who were treated by transurethral plasmakinetic resection of prostate( TPKRP) combined with cystolithotomy via small incision on the lower abdomen were retrospectively analyzed. Results The operations were successfully completed in all 30 patients. TPKRP time was 50 ~ 108 min,with a mean time of 72 min. The time of suprapubic bladder lithotomy 20 ~ 45 min,the mean time of 38 min. Intraoperative blood loss was about 150 ~ 250 ml,with an average 215 ml. There were no cases of serious complications. The patients were followed up for 2 to 24 months. The average score of International Prostate Symptom Score( IPSS) was 6. 6 points. The average score of quality of life( QOL) was 1. 8 points. The average flow rate( AFR) was 13. 8 ml / s. Conclusion Bipolar plasmakinetic resection of prostate combined with cystolithotomy via small incision on lower abdomen in the treatment of BHP patients with huge bladder stones is a safe,efficient and saving surgery,and is suitable for popularization and application in primary hospitals.
Objective To explore the effective methods to treat benign prostatic hyperplasia( BPH) patients with huge bladder stones. Methods The data of 34 BPH patients with huge bladder stone who were treated by transurethral plasmakinetic resection of prostate( TPKRP) combined with cystolithotomy via small incision on the lower abdomen were retrospectively analyzed. Results The operations were successfully completed in all 30 patients. TPKRP time was 50 ~ 108 min,with a mean time of 72 min. The time of suprapubic bladder lithotomy 20 ~ 45 min,the mean time of 38 min. Intraoperative blood loss was about 150 ~ 250 ml,with an average 215 ml. There were no cases of serious complications. The patients were followed up for 2 to 24 months. The average score of International Prostate Symptom Score( IPSS) was 6. 6 points. The average score of quality of life( QOL) was 1. 8 points. The average flow rate( AFR) was 13. 8 ml / s. Conclusion Bipolar plasmakinetic resection of prostate combined with cystolithotomy via small incision on lower abdomen in the treatment of BHP patients with huge bladder stones is a safe,efficient and saving surgery,and is suitable for popularization and application in primary hospitals.
引文
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2 吴阶平.泌尿外科学[M].济南:山东科学技术出版社,2004:1143-1145.
3 石理华,庞自力,李辉,等.腔内手术同期治疗良性前列腺增生合并膀胱结石[J].临床泌尿外科杂志,2006,21(12):551-552.
4 赵晓风,孙晓飞,吕志红,等.经尿道前列腺等离子双极电切和经尿道前列腺电切治疗良性前列腺增生的临床结果比较[J].中华泌尿外科杂志,2006,27(9):628-630.
5 刘肇华,杨志坚,陈敏坚,等.经尿道等离子电切术治疗前列腺增生(附780例)[J].广东医学杂志,2011,32(17):2307-2308.
6 梁庆祖,黄华武,韦立煌,等.经尿道双极等离子电切术治疗前列腺增生(附40例报告)[J].中国临床新医学,2009,2(6):626-628.
7 刘江山,高兴成.前列腺增生并膀胱结石的腔内治疗[J].临床泌尿外科杂志,2001,16(12):519-520.
8 Hofmann R,Weber J,Heidenreich A,et al.Experimental studies and first clinical experience with a new Lithoclast and ultrasound combination for lithotripsy[J].Eur Urol,2002,42(4):376-381.
2 吴阶平.泌尿外科学[M].济南:山东科学技术出版社,2004:1143-1145.
3 石理华,庞自力,李辉,等.腔内手术同期治疗良性前列腺增生合并膀胱结石[J].临床泌尿外科杂志,2006,21(12):551-552.
4 赵晓风,孙晓飞,吕志红,等.经尿道前列腺等离子双极电切和经尿道前列腺电切治疗良性前列腺增生的临床结果比较[J].中华泌尿外科杂志,2006,27(9):628-630.
5 刘肇华,杨志坚,陈敏坚,等.经尿道等离子电切术治疗前列腺增生(附780例)[J].广东医学杂志,2011,32(17):2307-2308.
6 梁庆祖,黄华武,韦立煌,等.经尿道双极等离子电切术治疗前列腺增生(附40例报告)[J].中国临床新医学,2009,2(6):626-628.
7 刘江山,高兴成.前列腺增生并膀胱结石的腔内治疗[J].临床泌尿外科杂志,2001,16(12):519-520.
8 Hofmann R,Weber J,Heidenreich A,et al.Experimental studies and first clinical experience with a new Lithoclast and ultrasound combination for lithotripsy[J].Eur Urol,2002,42(4):376-381.