廖韶峰+马晓虎+唐昌盛

[摘要] 目的 對比同期手术和分期手术治疗良性前列腺增生（BHP）合并输尿管结石的临床疗效、可行性及经济性。 方法 选取2015年10月～2016年11月我院泌尿外科收治的良性前列腺增合并输尿管结石患者70例，其中同期手术35例、分期手术35例。比较两组患者手术前后残余尿量差值、手术前后最大尿流率差值、生活质量评分、国际前列腺症状评分、住院时间、人均医疗费用之间的差异。 结果 分期手术前后残余尿量差值（117.6±15.03）mL、最大尿流率差值（13.9±0.72）mL/s，与同期手术前后残余尿量差值（111.4±12.39）mL、最大尿流率差值（13.6±0.68）mL/s相比，差异无统计学意义（P>0.05）；同期手术生活质量评分（2.0±0.5）分、国际前列腺症状评分（8.3±2.6）分，较分期手术生活质量评分（2.2±0.3）分、国际前列腺症状评分（8.1±2.5）分比较，差异无统计学意义（P>0.05）；同期手术住院时间为（9.11±1.46）d、人均医疗费用为（3.07±0.58）万元，与分期手术住院时间为（14.3±1.62）d、人均医疗费用为（5.52±0.31）万元比较，差异有统计学意义（P<0.05）。 结论 同期手术治疗良性前列腺增生合并输尿管结石有较好的临床效果，同时能缩短住院时间、降低人均医疗费用，值得临床推广。

[关键词] 同期手术；前列腺增生；输尿管结石；分期手术

[中图分类号] R699 [文献标识码] A [文章编号] 2095-0616（2017）13-251-03

[Abstract] Objective To compare the clinical curative effect，feasibility and economy of simultaneous surgery and staged surgery for benign prostatic hyperplasia （BHP） complicated with ureteral calculi. Methods 70 cases of benign prostatic hyperplasia complicated with ureteral calculi cured in Department of Urology of our hospital from October 2015 to November 2016 were selected，including 35 cases of simultaneous surgery and 35 cases of staged surgery.Differences in residual urine volume，maximum postoperative urine flow difference，quality of life score，international prostate symptom score，length of stay， and per capita medical expenses before and after operation of the two groups were compared. Results The D-value of residual urine volume of staged surgery was （117.6±15.03）mL，and maximum urinary flow D-value was （13.9±0.72）mL/s before and after staging surgery.Compared with the D-value of residual urine volume （111.4±12.39）mL and maximum urine flow rate D-value （13.6±0.68）mL/s，the difference was not statistically significant （P>0.05）.The operative quality of life score of simultaneous surgery was （2.0±0.5），the International Prostate Symptom Score of simultaneous surgery was （8.3±2.6），compared with surgical staging quality of life score （2.2±0.3），the International Prostate Symptom Score （8.1±2.5） points，the differences were not statistically significant （P>0.05）.The hospital stay of simultaneous surgery was （9.11±1.46）days，and the average medical cost per person was （3.07±0.58）yuan.Compared with the staging operation，the hospitalization time was （14.3±1.62）days，the per capita medical expenses was （5.52+0.31）yuan，the difference was statistically significant （P<0.05）. Conclusion Simultaneous operative treatment of benign prostatic hyperplasia combined with ureteral calculi has a good clinical effect.At the same time，it can shorten the hospitalization time and lower the medical expenses per person.It is worthy of clinical promotion.

[Key words] Simultaneous surgery；Prostatic hyperplasia；Ureteral calculi；Staged surgery

钬激光前列腺剜除术（HoLEP）这一术式越来越多的应用于前列腺增生手术，其优点为术中出血少、手术时间短、电切综合征发生率低等[1]。一直以来对于良性前列腺增生合并输尿管结石者，通常采用分期手术，这不仅延长了治疗时间，而且增加了患者住院治疗费用。我院通过钬激光前列腺剜除术联合输尿管钬激光碎石术，同期手术治疗良性前列腺增生合并输尿管结石取得较好成效，现报道如下。

1 资料与方法