经尿道前列腺等离子电切术联合钬激光碎石术对老年前列腺增生并膀胱结石患者的疗效分析

目的 探讨经尿道前列腺等离子电切除术联合钬激光碎石对老年前列腺增生（BPH）合并膀胱结石患者的疗效。方法 选取2015 年1 月—2017 年12 月在浙江省医疗健康集团杭州医院采用经尿道前列腺等离子电切术联合钬激光碎石术治疗BPH 合并膀胱结石的80 例老年患者，随机分为对照组与观察组，每组40 例。对照组患者给予钬激光碎石术；观察组患者给予等离子电切术联合钬激光碎石术。观察两组患者住院期间相关指标及住院前后性功能，分析两组治疗前后炎症指标和应激指标。结果 观察组术中、术后出血量，留置导尿管时间、术后膀胱冲洗时间及住院时间优于对照组（P <0.05）。术后第3 天，观察组炎症指标和应激指标高于对照组（P <0.05）。治疗6 个月，两组国际勃起功能指数问卷表-5、中国早泄指数评分升高，国际前列腺症状评分下降（P <0.05）。两组治疗前后白细胞介素-2、白细胞介素-6、肿瘤坏死因子-α、内皮素-1 及前列腺素E2 比较，差异有统计学意义（P <0.05）。结论 经尿道前列腺等离子电切术联合钬激光碎石术对老年BPH 并膀胱结石患者住院期间及远期相关指标改善明显，值得推广。

Effect of transurethral resection of prostate combined with holmiumlaser lithotripsy on elderly patients with benign prostatichyperplasia and bladder stones

Objective To study the effect of transurethral plasma resection of prostate combined with holmiumlaser lithotripsy on elderly patients with benign prostatic hyperplasia and bladder stones. Methods Totally 80 elderlypatients with benign prostatic hyperplasia complicated with bladder stones were treated by transurethral resection ofprostate combined with holmium laser lithotripsy in our hospital from 2015 to 2017. They were randomly divided intocontrol group and observation group. The control group was treated with holmium laser lithotripsy. The observationgroup was treated with plasma resection combined with holmium laser lithotripsy. Relevant indexes, sexual function,inflammatory indexes and stress indexes during hospitalization, pre-hospitalization and post-hospitalization wereobserved. Results The bleeding volume, indwelling catheter time, bladder irrigation time and hospitalization timeof the observation group were better than those of the control group (P < 0.05). On the third day after operation, the inflammatory and stress indexes of the observation group were higher than those of the control group (P < 0.05). After6 months of treatment, IIEF-5 and CIPE scores increased and I-PSS scores decreased in both groups (P < 0.05). Therewere significant differences in IL-2, IL-6, TNF-a, ET-1 and PGE2 between the two groups before and after treatment(P < 0.05). Conclusion Transurethral plasma resection of prostate combined with holmium laser lithotripsy forelderly patients with benign prostatic hyperplasia and bladder stones has significant effect during hospitalization andlong-term improvement of related indicators, which is worthy of promotion.