经尿道双极等离子前列腺剜除术联合膀胱切开取石治疗高龄大体积良性前列腺增生合并膀胱结石的临床疗效

目的探讨经尿道双极等离子前列腺剜除术(PKEP)联合膀胱切开取石治疗高龄大体积良性前列腺增生(BPH)合并膀胱结石的临床疗效。方法回顾性分析2014年1月至2019年6月期间本院收治的126例高龄大体积BPH合并膀胱结石患者的临床资料。患者年龄≥70岁,前列腺重量≥80 g。按手术方式的不同分为研究组和对照组,研究组60例采用PKEP联合膀胱切开取石治疗,对照组66例采用经尿道钬激光膀胱碎石取石术联合PKEP治疗。对比两组手术时间、碎石取石时间、术中出血量、膀胱冲洗时间、术后留置导尿管时间、住院时间、住院费用、并发症等情况。结果 126例手术均由同一术者顺利完成,无严重并发症。术后复查结石清除率达100%。研究组与对照组的手术时间(72.2±13.1)min vs.(89.5±15.7)min]、碎石取石时间(25.6±8.4)min vs.(34.2±9.1)min]、住院费用(1.2±0.3)万元vs.(1.5±0.2)万元]比较,差异有统计学意义(P<0.01)。两组术中出血量、膀胱冲洗时间、留置尿管时间、住院时间、术后并发症、IPSS、QOL、Qmax比较,差异均无统计学意义(P>0.05)。结论 PKEP联合膀胱切开取石术治疗高龄大体积BPH并膀胱结石具有手术时间短、术中冲洗液吸收量少、碎石取石效率高、安全性好和经济成本低等诸多优点,值得临床推广应用。

Clinical efficacy of plasmakinetic enucleation of the prostate combined with bladder incision lithotomy for the treatment of elderly patients with large volume benign prostate hyperplasia complicated with bladder stones

Objective To explore the clinical efficacy of transurethral bipolar plasmakinetic-enucleation of the prostate(PKEP)combined with bladder incision lithotomy for the treatment of elderly patients with large volume(benign prostate hyperplasia)BPH complicated with bladder stones.Methods The clinical data of 126 elderly patients with large volume BPH complicated with bladder stones admitted to our hospital from January 2014 to June 2019 were retrospectively analyzed.The patients age≥70 years old,the weight of prostate≥80 g.According to the different of surgical methods,patients were divided into two groups.Sixty patients in the study group were treated with PKEP combined with bladder incision lithotomy.Sixty-six patients in the control group were treated with transurethral holmium laser lithotripsy combined with PKKP.Phe operation timet lithotomy or lithotripsy time,intraoperative blood loss,badder irrigation time,indwelling catheter time,hospital time,hospital costs,and complications were compared between the two groups.Results One hundred and twenty-six cases of surgery was completed successfully hv the same surgeon without serious complications.The stone clearance rate was 100%.The operation time(72.2±13.1)min vs.(89.5±15.7)m in],lithotomy or lithotripsy time(25.6±8.4)min vs.(34.2±9.1)min],hospital costs(1.2±0.3)vs.(1.5±0.2)]in study group were significantly lower than that in control group(P<0.0001).There were no signific ant differences in intraoperative hlood loss,bladder inigation time,indwelling catheter time,hospital time,complicalions,IPSS score,QOL score,and Qmax between the two groups(P>0.05).Conclusions PKEP combined with bladder incision lithotomy for the treatment of elderly patients with large volume of BPH complicated with bladder stones has many advantages such as shorter operating time,less intraoperative flushing fluid absorption,higher stone clearance efficiency,better safety and lower economic costs.It is worthy to clinical application.