CAJ | 학술논문

目的总结评价经尿道前列腺剜除后经膀胱卵圆钳取出治疗高危、大体积前列腺增生合并膀胱结石的临床疗效.方法本组60例75岁以上大体积前列腺增生合并膀胱结石患者,均行经尿道前列腺剜除术后,卵圆钳经膀胱腺体及结石一期取出,回顾性分析其临床资料及随访情况.结果患者年龄83.5±9.2(75 ～95)岁.经直肠B超测量前列腺大小为120.8±52.1(76 ～320)mL;合并膀胱结石长径3.47±1.2(1.7 ～6.0)cm;最大尿流率(5.4±2.1) ml/s、国际前列腺症状评分(30.7±4.2)分.60例手术均顺利完成,无中转开放术,无术中输血者；无闭孔神经反射、经尿道电切综合征(TURS)及死亡病例；手术时间50.9±15.3(40～85)min;术中出血30.3±10.5(20-100)mL.术后3个月复查尿流率、国际前列腺症状评分、生活质量评分均较术前明显改善；无尿失禁、迟发出血、尿道狭窄等发生.结论经尿道前列腺剜除后经膀胱卵圆钳取出术治疗高龄大体积前列腺增生合并膀胱结石安全可行、效果肯定.
목적 총결평개경뇨도전렬선완제후경방광란원겸취출치료고위、대체적전렬선증생합병방광결석적림상료효.방법 본조60례75세이상대체적전렬선증생합병방광결석환자,균행경뇨도전렬선완제술후,란원겸경방광선체급결석일기취출,회고성분석기림상자료급수방정황.결과 환자년령83.5±9.2(75 ～95)세.경직장B초측량전렬선대소위120.8±52.1(76 ～320)mL;합병방광결석장경3.47±1.2(1.7 ～6.0)cm;최대뇨류솔(5.4±2.1) ml/s、국제전렬선증상평분(30.7±4.2)분.60례수술균순리완성,무중전개방술,무술중수혈자；무폐공신경반사、경뇨도전절종합정(TURS)급사망병례；수술시간50.9±15.3(40～85)min;술중출혈30.3±10.5(20-100)mL.술후3개월복사뇨류솔、국제전렬선증상평분、생활질량평분균교술전명현개선；무뇨실금、지발출혈、뇨도협착등발생.결론 경뇨도전렬선완제후경방광란원겸취출술치료고령대체적전렬선증생합병방광결석안전가행、효과긍정.
Objectives To observe the feasibility and superiority of transurethral enucleation of the prostate (TUEP) and trans- bladder removal by oval forceps for giant benign prostatic hyperplasia(BPH) combined with bladder calculi.Methods Data of 60 cases of BPH combined with bladder calculi,to whom transurethral enucleation of the prostate (TUEP) and trans- bladder removal by oval forceps were performed,were retrospectively studied.Results The age of patients was 83.5 ± 9.2 ( range from 75 to 95) years old.The transrectal ultrasound (TRUS) revealed BPH and calculated prostatic gland volume was 120.8 ± 52.1 ( range from 76 to 320 ) mL.bladder calculus diameter was 3.47 + 1.2 ( 1.7 - 6.0 ) cm,the maximum flow rate ( MFR ) was ( 5.4 ± 2.1 ) ml/s,the international prostate score symptoms (IPSS) was ( 30.7 ± 4.2 ) ; This technique was successfully performed on 60 patients.No patient required conversion to open surgery.Blood transfusion,transurethral resection syndrome(TURS),and death cases was not found in this group of patients.The mean operative time was 50.9 ± 15.3 ( range from 40 to 85 ) minutes and the estimated blood loss was 30.3 ± 10.5 ( range from 20 to 100 ) mL.Significant improvement was noted in MFR,IPSS and the QOL three months after surgery.No urinary incontinence,bled postoperation,and urethremphraxis was reported.Conclusions Transurethral enucleation of the prostate (TUEP) and trans - bladder removal by oval forceps for giant benign prostatic hyperplasia(BPH) combined with bladder calculi is feasible,superior and reproducible.