李寿强+赵云

【摘要】 目的 探討分析前列腺增生症合并膀胱结石手术方法的选择。方法 120例前列腺增生症合并膀胱结石的男性患者， 随机分为对照组和观察组， 各60例。对照组实施经尿道前列腺电切术+经尿道腔内碎石取石术治疗， 观察组实施经尿道前列腺电切术+耻骨上小切口膀胱切开取石治疗。分析比较两组的临床治疗效果。结果 观察组患者的取石时间、手术总时间、术中出血量均优于对照组， 差异均具有统计学意义（P<0.05）。观察组碎石成功率93.33%高于对照组的80.00%， 差异具有统计学意义（P<0.05）。观察组患者并发症发生率6.67%明显低于对照组的20.00%， 差异具有统计学意义（P<0.05）。术后6个月进行回访发现观察组患者的结石复发率1.67%明显低于对照组的11.67%， 差异具有统计学意义（P<0.05）。观察组患者生活质量评分高于对照组， 差异具有统计学意义（P<0.05）。结论 经尿道前列腺电切术+耻骨上小切口膀胱切开取石术治疗前列腺增生症合并膀胱结石（直径>3 mm）患者安全有效， 有利于缩短取石时间、手术总时长， 减少术中出血量， 碎石成功率高， 并发症发生率低， 术后复发率低， 有利于提高患者的生活质量， 值得在临床上进一步推广。

【关键词】 前列腺增生症；膀胱结石；手术方法

DOI：10.14163/j.cnki.11-5547/r.2018.05.001

【Abstract】 Objective To discuss and analyze the surgical methods of prostatic hyperplasia complicated with bladder stones. Methods A total of 120 male patients with prostatic hyperplasia complicated with bladder stones were randomly divided into control group and observation group， with 60 cases in each group. The control group was treated with transurethral resection of prostate + transurethral lithotripsy， and the observation group was treated with transurethral resection of prostate + small suprapubic bladder incision stone. The clinical treatment effect in two groups was analyzed and compared. Results The observation group had better stone removal time， total operation time， intraoperative bleeding volume than the control group， and their difference was statistically significant （P<0.05）. The observation group had higher success rate of lithotripsy as 93.33% than 80.00% in the control group， and the difference was statistically significant （P<0.05）. The observation group had obviously lower incidence of complications as 6.67% than 20.00% in the control group， and the difference was statistically significant （P<0.05）. In postoperative 6 months of follow-up， the observation group had obviously lower recurrence rate of stones as 1.67% than 11.67% in the control group， and the difference was statistically significant （P<0.05）. The observation group had higher quality of life score than the control group， and the difference was statistically significant （P<0.05）. Conclusion Transurethral resection of prostate + small suprapubic bladder incision stone is safe and effective in treating patients with prostatic hyperplasia complicated with bladder stones （diameter>3 mm）， and it is beneficial for shortening stone removal time， total operative time， reducing intraoperative bleeding volume with high success rate of lithotripsy， low complication rate and low postoperative recurrence rate， which is conducive to improving the quality of life of patients. It is worthy of further promotion in clinic.endprint

【Key words】 Prostatic hyperplasia； Bladder stones； Surgical methods

良性前列腺增生是中老年男性排尿障碍中最常见的一种良性病变[1]， 膀胱结石是前列腺增生的常见合并症之一[2]。为了探讨前列腺增生症合并膀胱结石手术方法的选择， 本院特作此次研究， 具体报告如下。

1 资料与方法

1. 1 一般资料 选取2015年5～7月于本院泌尿外科行手术治疗的120例前列腺增生症合并膀胱结石的男性患者作为研究对象， 随机分为对照组和观察组， 各60例。观察组患者年龄40～70岁， 平均年龄（43.22±8.93）岁。对照组患者年龄40～69岁， 平均年龄（44.11±8.30）岁。两组患者年龄等一般资料比较差异无统计学意义（P>0.05）， 具有可比性。所有患者均已签署知情同意书， 此次研究经本院伦理会同意。

1. 2 纳入及排除标准[3] 纳入标准：所有患者均有尿路刺激征、进行性的排尿困难、尿潴留、尿失禁， 患者经直肠指检可触及增大的前列腺尿流动力学检查患者的最大尿流率<10 ml/s， 膀胱结石（+）， 膀胱结石直径>3 mm。排……