经尿道前列腺汽化电切联合耻骨上小切口手术对良性前列腺增生合并大膀胱结石的疗效分析

桑海明+郭祯远+孙云+褚勇+冷梅

[摘要] 目的 研究經尿道前列腺汽化电切联合耻骨上小切口手术对良性前列腺增生合并大膀胱结石的疗效。 方法 选取我院2014年2月～2017年8月收治的良性前列腺增生合并大膀胱结石患者84例为观察对象，以随机数字表法分成观察组与对照组各42例。对照组给予开放性手术，观察组则予以经尿道前列腺汽化电切联合耻骨上小切口手术，分别对比两组结石清除率、结石复发率、并发症发生率、各项手术指标、治疗前后前列腺症状评分（IPSS）以及生活质量变化情况。 结果 两组结石清除率均为100.00%（42/42），结石复发率对比不明显。而观察组并发症发生率为2.38%（1/42），显著低于对照组的14.29%（6/42）。观察组最大尿速率为（16.1±1.8）mL/s，显著高于对照组的（12.3±1.5）mL/s，而导尿管留置时间、住院时间分别为（3.9±0.5）、（6.3±2.2）d，均显著低于对照组的（8.8±2.8）、（11.2±4.1）d。术后观察组与对照组的IPSS评分分别为（7.4±0.5）、（13.5±0.8）分，均显著低于术前，而观察组又显著低于对照组。术后观察组与对照组的QOL评分分别为（48.2±10.3）、（38.9±8.2）分，均显著高于术前，而观察组又显著高于对照组。以上对比均差异有统计学意义（P<0.05）。 结论 经尿道前列腺汽化电切联合耻骨上小切口手术治疗良性前列腺增生合并大膀胱结石的疗效明显，可有效降低并发症发生率，促进患者早日康复，改善患者临床症状并提高生活质量。

[关键词] 良性前列腺增生；膀胱结石；小切口手术；前列腺汽化电切；疗效

[中图分类号] R699 [文献标识码] A [文章编号] 2095-0616（2017）20-189-04

Curative effect of transurethral vaporization of prostate combined with Suprapubic small incision surgery for benign prostatic hyperplasia complicated with large vesical calculi

SANG Haiming GUO Zhenyuan SUN Yun CHU Yong LENG Mei

Department of Urology Surgery， the People's Hospital of Shihezi City， Shihezi 832000， China

[Abstract] Objective To study the curative effect of transurethral vaporization of prostate combined with Suprapubic small incision surgery for benign prostatic hyperplasia complicated with large vesical calculi. Methods 84 cases of benign prostatic hyperplasia complicated with large vesical calculi treated in our hospital from February 2014 to August 2017 were selected as observation objects. All patients were randomly divided into observation group and control group with 42 cases in each group. The patients of control group were given open surgery， while the patients of observation group were treated with transurethral vaporization of prostate combined with Suprapubic small incision surgery. The stone clearance rate， stone recurrence rate， complication rate， operation index， prostate symptom score （IPSS） before and after treatment and quality of life were compared between the two groups. Results The stone clearance rate of the two groups were 100% （42/42）， and the stone recurrence rate was not obvious. The complication rate of the observation group was 2.38% （1/42）， which was significantly lower than that of the control group （14.29%， 6/42）. The maximum urine rate of observation group was （16.1±1.8） mL/s， and significantly higher than that of control group which was （12.3±1.5） mL/s， and the catheter indwelling time， hospitalization time were （3.9±0.5）d， （6.3±2.2） d respectively， and significantly lower than those of control group which were （8.8±2.8） d， （11.2±4.1） d. The postoperative IPSS scores of the observation group and the control group were （7.4±0.5） points， （13.5±0.8） points， all significantly lower than those before the operation， while the IPSS scores of observation group was significantly lower than that of control group. The postoperative QOL scores of the observation group and the control group were （48.2±10.3） points， （38.9±8.2） points， all significantly higher than those before the operation， while the QOL scores of observation group was significantly higher than that of control group. All the differences between the two groups were statistically significant （P<0.05）. Conclusion The curative effect of transurethral vaporization of prostate combined with Suprapubic small incision surgery in the treatment of benign prostatic hyperplasia complicated with large vesical calculi is obvious， can effectively reduce the incidence of complications， promote early rehabilitation of patients， improve clinical symptoms and improve the quality of life.endprint

[Key words] Benign prostatic hyperplasia； Vesical calculi； Small incision surgery； Transurethral vaporization of prostate； Effect

前列腺属于男性生殖器官最大的附属性腺，是男性独有的器官[1]。由于前列腺腺体中间存在尿道，因此当前列腺发生肥大增生时会对尿道产生一定程度的影响，如患者未得到及时有效的处理，易发生炎症，导致尿淤积进而形成结石[2]。前列腺增生合并膀胱结石会导致患者出现排尿困难、尿痛以及反复泌尿系感染等症状，给患者带来极大的痛苦，对患者的生活质量造成严重影响，目前临床上主要是采用手术进行治疗[3]。……