中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
12期
2192-2195
,共4页
膀胱结石%前列腺增生%经尿道前列腺切除术
膀胱結石%前列腺增生%經尿道前列腺切除術
방광결석%전렬선증생%경뇨도전렬선절제술
Urinary bladder calculi%Prostatic hyperplasia%Transurethral resection of prostate
目的：探讨良性前列腺增生症合并＞3 cm膀胱结石的手术方式选择。方法回顾性分析罗定市人民医院良性前列腺增生症合并膀胱结石患者的临床资料，按膀胱结石碎石取石方法不同分为两组，试验组：耻骨上小切口膀胱切开取石＋经尿道前列腺电切术（TURP）；对照组：经尿道腔内碎石取石＋TURP。统计比较两组患者的一般临床资料，术中评价指标和术后膀胱结石残留及并发症发生情况。结果126例患者纳入研究，所有患者手术均成功，试验组30例，对照组96例（气压弹道碎石47例，钬激光碎石49例）。两组患者年龄、结石直径、前列腺大小、术前IPSS评分和QOL评分均无统计学差异（P＞0.05）。试验组碎石取石时间和总手术时间均较对照组短，差异具有统计学意义（P＜0.001）。试验组所有患者术后复查KUB无结石残留；对照组患者术后复查KUB提示结石残留9例，其中气压弹道碎石组4例，钬激光组5例。两组患者均无电切综合征、大出血中转开放手术或二次手术等严重并发症发生。结论耻骨上小切口膀胱切开取石＋TURP治疗前列腺增生合并＞3 cm膀胱结石安全有效，尤其是合并膀胱小梁小室者，可缩短手术时间，减少术后膀胱结石残留发生率，值得临床推广。
目的：探討良性前列腺增生癥閤併＞3 cm膀胱結石的手術方式選擇。方法迴顧性分析囉定市人民醫院良性前列腺增生癥閤併膀胱結石患者的臨床資料，按膀胱結石碎石取石方法不同分為兩組，試驗組：恥骨上小切口膀胱切開取石＋經尿道前列腺電切術（TURP）；對照組：經尿道腔內碎石取石＋TURP。統計比較兩組患者的一般臨床資料，術中評價指標和術後膀胱結石殘留及併髮癥髮生情況。結果126例患者納入研究，所有患者手術均成功，試驗組30例，對照組96例（氣壓彈道碎石47例，鈥激光碎石49例）。兩組患者年齡、結石直徑、前列腺大小、術前IPSS評分和QOL評分均無統計學差異（P＞0.05）。試驗組碎石取石時間和總手術時間均較對照組短，差異具有統計學意義（P＜0.001）。試驗組所有患者術後複查KUB無結石殘留；對照組患者術後複查KUB提示結石殘留9例，其中氣壓彈道碎石組4例，鈥激光組5例。兩組患者均無電切綜閤徵、大齣血中轉開放手術或二次手術等嚴重併髮癥髮生。結論恥骨上小切口膀胱切開取石＋TURP治療前列腺增生閤併＞3 cm膀胱結石安全有效，尤其是閤併膀胱小樑小室者，可縮短手術時間，減少術後膀胱結石殘留髮生率，值得臨床推廣。
목적：탐토량성전렬선증생증합병＞3 cm방광결석적수술방식선택。방법회고성분석라정시인민의원량성전렬선증생증합병방광결석환자적림상자료，안방광결석쇄석취석방법불동분위량조，시험조：치골상소절구방광절개취석＋경뇨도전렬선전절술（TURP）；대조조：경뇨도강내쇄석취석＋TURP。통계비교량조환자적일반림상자료，술중평개지표화술후방광결석잔류급병발증발생정황。결과126례환자납입연구，소유환자수술균성공，시험조30례，대조조96례（기압탄도쇄석47례，화격광쇄석49례）。량조환자년령、결석직경、전렬선대소、술전IPSS평분화QOL평분균무통계학차이（P＞0.05）。시험조쇄석취석시간화총수술시간균교대조조단，차이구유통계학의의（P＜0.001）。시험조소유환자술후복사KUB무결석잔류；대조조환자술후복사KUB제시결석잔류9례，기중기압탄도쇄석조4례，화격광조5례。량조환자균무전절종합정、대출혈중전개방수술혹이차수술등엄중병발증발생。결론치골상소절구방광절개취석＋TURP치료전렬선증생합병＞3 cm방광결석안전유효，우기시합병방광소량소실자，가축단수술시간，감소술후방광결석잔류발생솔，치득림상추엄。
ObjectiveTo explore the choice of operation method for bladder stone (>3 cm) with benign prostatic hyperplasia.Methods A retrospective record study was conducted of patients with bladder stones complicated with benign prostatic hyperplasia, categorized by the method of Gravel method. Study group: suprapubic small cut method+TURP; control group: transurethralmethod+TURP. Patient demographics, baseline characteristics, and operative and postoperative outcomes were compared.Results 126 patients included study (study group: 30, control group: 96), and all operations were successful. No significant difference was observed between groups in age, cumulative stone diameter, and prostatic volume(P>0.05). Patients undergoing suprapubic small cut method had shorter stone removal time and total operative time(P<0.001). Residual stones were more commonly in the control group than in the study group (study group: 0, control group: 9 cases). No seriously complications were recorded.Conclusion Suprapubic small cut method in combination with TURP is safe and effective for the management of bladder stone (>3 cm) with benign prostatic hyperplasia, especially combined with diverticula, leading to decreased stone residual rate and operative time, which deserves further clinical promotion.
