CAJ | 학술논문

目的：探讨经皮膀胱微造瘘通道钬激光碎石联合经尿道前列腺电切术（TURP）治疗前列腺增生症（BPH）并发膀胱结石的临床效果。方法选取2009年3月-2013年3月就诊的52例BPH合并膀胱结石患者，采用经皮膀胱穿刺微造瘘、输尿管镜下钬激光碎石术联合TURP治疗组与47例单纯采用TURP治疗BPH合并膀胱结石作比较。结果改进组52例及对照组47例均顺利完成手术，膀胱碎石时间（23±18.5）min和（28.5±22.5）min。TURP时间（55±24）min和（61.5±29）min。改进组无大出血、膀胱穿孔、尿失禁、严重感染、前列腺电切综合征（TURS）等并发症，对照组出现5例并发症。术后住院时间（5.5±3.2）d和（6.2±3.2）d。1个月后复查尿流率（-22±3.8）mL/s和（19.5±3.5）mL/s。术后均随访6～12个月，超声检查未见结石复发，无尿失禁及排尿不畅症状。结论经皮膀胱穿刺微造瘘钬激光碎石联合TURP治疗BPH合并膀胱结石能有效缩短手术时间，减少损伤，恢复快，疗效安全。
목적：탐토경피방광미조루통도화격광쇄석연합경뇨도전렬선전절술（TURP）치료전렬선증생증（BPH）병발방광결석적림상효과。방법선취2009년3월-2013년3월취진적52례BPH합병방광결석환자，채용경피방광천자미조루、수뇨관경하화격광쇄석술연합TURP치료조여47례단순채용TURP치료BPH합병방광결석작비교。결과개진조52례급대조조47례균순리완성수술，방광쇄석시간（23±18.5）min화（28.5±22.5）min。TURP시간（55±24）min화（61.5±29）min。개진조무대출혈、방광천공、뇨실금、엄중감염、전렬선전절종합정（TURS）등병발증，대조조출현5례병발증。술후주원시간（5.5±3.2）d화（6.2±3.2）d。1개월후복사뇨류솔（-22±3.8）mL/s화（19.5±3.5）mL/s。술후균수방6～12개월，초성검사미견결석복발，무뇨실금급배뇨불창증상。결론경피방광천자미조루화격광쇄석연합TURP치료BPH합병방광결석능유효축단수술시간，감소손상，회복쾌，료효안전。
Objective To study the percutaneous bladder micro channel lithotripsy with holmium laser combined with transurethral resection of the prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH) clinical effect of combined with bladder stone. Methods from 2009 March to 2013 March in our hospital for treatment of 52 cases of BPH combined with bladder calculi patients, percutaneous bladder puncture fistulization, TURP with holmium laser lithotripsy under ureteroscope in treatment group and 47 cases treated by TURP BPH combined with bladder calculi compared. Results the improved group 52 cases and control group of 47 cases were successfully completed the operation, bladder stone time was (23 ± 18.5) min and (28.5 ± 22.5) min. (55 ± 24) min and (61.5 ± 29) min. The improved group no bleeding, perforation of the bladder, urinary incontinence, severe infection, transurethral resection syndrome (TURS) and other complications, the control group had 5 cases with complications. The postoperative hospital stay was (5.5 ± 3.2) d and (6.2 ± 3.2)d. 1 months after the urine flow rate (-22 ± 3.8 )mL/s and (19.5 ± 3.5)mL/s. All patients were followed up for 6-12 months, no stone recurrence check without ultrasound, urinary incontinence and voiding difficulty symptom. Conclusion percutaneous bladder puncture fistulization holmium laser lithotripsy combined with TURP in the treatment of BPH complicated with bladder stones can effectively shorten the operation time, less injury, quick recovery, safety.