经尿道前列腺等离子电切术联合气压弹道碎石术治疗高龄高危前列腺增生并膀胱结石的临床效果

目的探讨经尿道前列腺等离子电切术联合气压弹道碎石术治疗高龄高危前列腺增生并膀胱结石临床疗效。方法选择2011年1月至2012年12月我院收治的高龄高危前列腺增生（BPH）合并膀胱结石患者76例，随机分为2组：A组38例，采用经尿道前列腺等离子电切术联合气压弹道碎石术治疗；B组38例，采用经尿道前列腺等离子电切术联合耻骨上小切口切开取石术治疗。比较两组手术时间、术中出血量、膀胱冲洗时间、置管时间、术后住院时间、近期并发症，术前、术后3个月最大尿流率（MFR）、残余尿量、术前国际前列腺症状评分（IPSS）、生活质量（QOL）评分、梗阻评分。结果A组术中出血量、膀胱冲洗时间、置管时间、住院时间明显优于B组（P〈0．05），A组术后3个月MFR、残余尿量、IPSS评分、QOL评分、梗阻评分改善程度比B组明显（P〈0．05）。结论在充分做好术前、术中、术后处理和把握好禁忌证前提下，经尿道前列腺等离子电切术联合气压弹道碎石术可作为高龄高危BPH并膀胱结石患者首选手术方法。

Clinical efficacy of transurethral plasmakinetic resection combined with pneumatic lithotripsy in the treatment of prostatic hyperplasia and bladder stones in patients with advanced age and high risk

Objective To investigate the efficacy of transurethral plasmakinetic resection combined with pneumatic lithotripsy in treating benign prostatic hyperplasia （BPH） and bladder stones in patients with advanced age and high risk. Methods A number of 76 patients with BPH combined with bladder calculi treated in our hospital during Jan. 2011 to Dec. 2012 were randomly divided into two groups, with 38 patients in either group. Group A was treated by transurethral plasmakinctic resection combined with pneumatic lithotripsy, group B by transurethral plasmakinetie resection of the prostate and suprapubic small incision to remove stones. The operation time, intraoperative bleeding volume, bladder irrigation time, intubation time, post- operative hospitalization, complications, maximum flow rate （MFR） 3 months before and after operation, residual urine volume, International Prostate Symptom Score （IPSS）, Quality of Life （QOL） score, and obstruction score of the two groups were compared. Results The intraoperative bleeding volume, bladder irrigation time, intubation time, postoperative hospitalization time of group A were better than those of group B （P〈0. 05 ）. The MFR, residual urine volume, IPSS score, QOL score, obstruction score of group A were improved significantly more than those of group B （P〈0. 05）. Conclusions With sufficient preoperative, intraoperative, and postoperative management, transurethral plasmakinetie resection combined with pneumatic lithotripsy is optimal for high-age and high-risk patients with BPH and bladder stones.