摘要
目的 探讨三种手术方法治疗良性前列腺增生（benign prostatic hyperplasia,BPH）合并膀胱结石的疗效及对性功能的影响差异.方法 选取本院2014年1月至2016年12月期间收治的156例BPH合并膀胱结石患者,根据手术方式分为开放手术组（A组,46例）、经尿道前列腺电切术（transurethral resection of the prostate,TURP）联合钬激光组（B组,57例）、经尿道双极等离子前列腺切除（transurethral plasmakinetic resection of prostate,PKRP）联合钬激光组（C组,53例）.观察三组手术情况及手术前、手术后6个月国际前列腺症状评分（international prostate symptom score,IPSS）、最大尿流率（maximum flow rate,Qmax）及残余尿量（residual urine volume RUV）、IIEF-5性功能评分及并发症发生情况等指标.结果 C组手术时间、术中出血量、膀胱冲洗时间、尿管留置时间以及住院时间均显著低于A组和B组,差异有统计学意义（P＜0.05）.术后6个月三组IPSS、Qmax及RUV评分较术前明显改善,且B组、C组各指标均显著优于A组,差异有统计学意义（P＜0.05）.术后6个月C组勃起功能障碍发生率、IIEF-5评分及术后并发症发生率显著低于A组和B组,差异有统计学意义（P＜0.05）.结论 三种术式均为BPH合并膀胱结石有效治疗方法,但PKRP联合钬激光碎石治疗BPH合并膀胱结石对患者性功能影响小,提高了生活质量,值得临床推广.
Objective To investigate influences on the efficacy and sexual function of three different procedures for benign prostatic hyperplasia （BPH） combined with bladder stone.Methods Totally 156 patients with BPH combined with bladder stone were collected from Junuary 2014 to December 2016 in our hospital,which were divided into open surgery group （group A,46 cases）,tran surethral resection of the prostate （TURP） combined with holmium laser group （group B,57 cases）,transurethral plasmakinetic resection of prostate （PKRP） combined with holmium laser group （group C,53 cases） according to the surgical methods.The International Prostate Symptom Score （IPSS）,maximum flow rate （Qmax） and residual urine volume （RUV）,international index of erectile function （IIEF-5） scores and sexual function,complications in 3 groups were observed.Results The peration time,intraoperative bleeding,bladder irrigation time,catheter indwelling time and hospitalization time of the group C were significantly lower than those of group A and B （P 〈 0.05）.The IPSS score,Qmax and RUV of the 3 groups were significantly improved after operation,and those of group B and C were significantly better than those of the group A （P 〈 0.05）.The incidence of erectile dysfunction,IIEF-5 scores and postoperative complications of group C were significantly lower than that of group A and B（P 〈 0.05）.Conclusions The three operations are both effective methods for BPH combined with bladder stone,but PKRP combined with holmium laser lithotripsy for BPH combined with bladder stone has less negative influences for sexual function,it is worthy of clinical promotion.
作者
蒋涛
莫承强
李虎
王锋锋
何祖强
Jiang Tao;Mo Chengqiang;Li Hu(Department of Urology,the Maternal and Child Health Care Hospital of Baiyun District,Guangzhou 510410,China;Department of Urology,the First Affiliated Hospital of Zhongshan University,Guangzhou 510410,China)
出处
《国际泌尿系统杂志》
2018年第4期571-574,共4页
International Journal of Urology and Nephrology
关键词
前列腺增生
膀胱结石
经尿道前列腺切除术
电外科手术
Prostatic Hyperplasia
Urinary Bladder Calculi
Transurethral Resection of Prostate
Electrosurgery
