微创治疗良性前列腺增生并膀胱结石的最佳方法探讨

目的探讨微创治疗良性前列腺增生并膀胱结石的最佳方法。方法选择127例良性前列腺增生合并膀胱结石的患者,分别采用大力碎石钳碎石加经尿道前列腺电切术(TURP)(A组,45例)、经膀胱镜钬激光碎石加TURP术(B组,42例)、小切口开放取石加TURP术(C组,40例)治疗。观察三组一期手术成功率,碎石、取石时间、住院时间、出现膀胱黏膜损伤和膀胱穿孔改开放手术的例数。结果 B组碎石取石时间显著长于A组、C组,但是住院时间明显短于A组和C组。在B组中,术中发生膀胱或前列腺损伤共为3例,损伤率显著小于A组(12例)(χ2=5.632,P=0.023)。B组因膀胱穿孔或结石无法粉碎改为开放手术率为0,A组为20.0%,B组明显低于A组,差异有显著性(χ2=13.642,P0.001)。结论钬激光碎石结合TURP治疗前列腺增生合并膀胱结石具有损伤小、疗效好、恢复快等优点,虽碎石取石时间延长,但手术并发症少,值得临床推广。

Comparison in minimally invasive treatment of benign prostatic hyperplasia and bladder stones

Objective To investigate the best minimally method in treating benign prostatic proliferate and bladder calculi. Methods 127 cases of benign prostatic hyperplasia and bladder stones were collected into this study. Gravel pliers plus transurethral resection（ TURP）sur-gery were used in A group（45 cases）,holmium laser lithotripsy by cystoscopy plus TURP surgery were performed in group B（42 patients）. And a small incision open surgery plus TURP in group C（40 patients）were taken. Major surgical results were compared in the three groups. Results In Group B,lithotripsy was significantly higher in group A and group C,but the length of hospital stay was significantly less than in group A and group C. In Group B. The total three cases had injury in the bladder or prostate surgery,with the damage significantly less than that in group A（12 cases）（χ^2 =5. 632,P =0. 023）. In group B,rates of change to open surgery due to bladder perforation or crushed stone were 0. 00%,but it was up to 20. 0% in group A,with significant differences between the two groups（χ^2 =13. 642,P 〈0. 001）. Conclusion Holmium laser litho-tripsy combined with TURP for benign prostatic hyperplasia and bladder stones have a small injury,efficacy,quick recovery. Although this method is prolonged,this method have fewer surgical complications,which is worthy of promotion.