摘要
目的探讨前列腺增生（BPH）合并膀胱结石同期手术的临床疗效及安全性。方法采用电切镜电切环将结石钩出、气压弹道碎石、小切口膀胱切开取石3种方法治疗膀胱结石,而后采用经尿道前列腺电切术（TURP）治疗BPH并膀胱结石51例。结果效果良好,切口Ⅰ期愈合、无切口感染、尿漏、尿失禁等并发症,但有4例尿道外口狭窄经行尿道扩张治愈。随访6个月~5年,所有患者排尿通畅,术后最大尿流率〉15 m l,残余尿量〈20 m l,国际前列腺症状评分0~8分,无膀胱结石复发。结论 BPH合并膀胱结石同期手术的治疗：对于膀胱小结石可行电切镜电切环直接将结石钩出;对较大结石行腔内气压弹道碎石;而对大结石或多发性结石从手术时间及安全性来考虑,行小切口膀胱切开取石。根据结石大小及多发情况分别行以上3种方法治疗膀胱结石,而后行TURP,方法简单、创伤小、恢复快、效果确切、安全,值得临床推广应用。
Objective To explore the therapeutic effects and the safety of simultaneous surgical treatment for patients with benign prostate hyperplasia（BPH） complicated with vesical calculi.Methods A total of 51 cases of BPH with vesical calculi underwent calculus removal by resectoscope,air pressure ballistic lithotripsy,or by mini-incisions cystolithotomy followed by transurethral resection of the prostate（TURP）.Results All the operations were successful with primary healing.No incision infection,urinary leakage,or incontinence were noticed,except for 4 cases of urethral external aperture strictures which recovered after urethral sounding.During the subsequent follow-up ranging from 6 months to 5 years,all patients showed a postoperative peak urinary flow rate of more than 15 ml,a residual urine volume of less than 20 mL;International Prostatic Symptom Score（IPSS） ranged from 0 to 8;no dysuria or bladder stones recurrence in was noted.Conclusion For simultaneous surgical treatment,small bladder stones should be removed directly by resectoscope,while air pressure ballistic lithotripsy should be applied for bigger stones,and mini-incisions cystolithotomy could be the option for either big or multiple calculi in considerasion of operative duration and safety.The following TURP is an effective,safe,simple,minimally invasive method with a short recovery time.Simultaneous surgical treatment should be applied more widely for patients with BPH and bladder calculi.
出处
《中国全科医学》
CAS
CSCD
北大核心
2011年第20期2319-2321,共3页
Chinese General Practice
关键词
前列腺增生
膀胱结石
气压弹道碎石
膀胱切开术
经尿道前列腺电切术
Prostate hyperplasia
Urinary baldder calculi
Ballistic lithotripsy
Cystotomy
Transurethral resection of the prostate
