CAJ | 학술논문

目的探讨经尿道双极等离子前列腺剜除(TUPKEP)联合耻骨上小切口治疗高危高龄前列腺增生(BPH)合并膀胱结石的安全性和疗效.方法回顾分析解放军第三○三医院收治的68例采用TUPKEP联合耻骨上小切口手术方式治疗的高危高龄BPH合并膀胱结石患者的临床资料.结果 68例患者均顺利完成手术,术中术后无电切综合征、休克、心肌梗死、脑梗死、脑出血、永久性尿失禁、切口感染等并发症.暂时性尿失禁7例,平均恢复时间(9.48±1.52)d.平均手术时间(48.63 ±4.14) min,术中平均出血量(50.97±5.33) ml.与术前相比,术后最大尿流率(Qmax),国际前列腺症状评分(I-PSS),生活质量评分(QOL)差异均有统计学意义.术前术后Qmax分别为(4.56±0.35)ml/s和(18.82±1.65) ml/s(P＜0.001).术前术后I-PSS分别为(21.96±1.89)分和(11.23±0.86)分(P=0.018).术前术后QOL分别为(4.94 ±0.35)分和(1.95±0.32)分(P＝0.011).结论 TUPKEP联合耻骨上小切口治疗高危高龄BPH合并膀胱结石安全有效.
목적 탐토경뇨도쌍겁등리자전렬선완제(TUPKEP)연합치골상소절구치료고위고령전렬선증생(BPH)합병방광결석적안전성화료효.방법 회고분석해방군제삼○삼의원수치적68례채용TUPKEP연합치골상소절구수술방식치료적고위고령BPH합병방광결석환자적림상자료.결과 68례환자균순리완성수술,술중술후무전절종합정、휴극、심기경사、뇌경사、뇌출혈、영구성뇨실금、절구감염등병발증.잠시성뇨실금7례,평균회복시간(9.48±1.52)d.평균수술시간(48.63 ±4.14) min,술중평균출혈량(50.97±5.33) ml.여술전상비,술후최대뇨류솔(Qmax),국제전렬선증상평분(I-PSS),생활질량평분(QOL)차이균유통계학의의.술전술후Qmax분별위(4.56±0.35)ml/s화(18.82±1.65) ml/s(P＜0.001).술전술후I-PSS분별위(21.96±1.89)분화(11.23±0.86)분(P=0.018).술전술후QOL분별위(4.94 ±0.35)분화(1.95±0.32)분(P＝0.011).결론 TUPKEP연합치골상소절구치료고위고령BPH합병방광결석안전유효.
Objective To explore the safety and efficiency of transurethral plasmakinetic enucleation of prostate (TUPKEP) and suprapubic small cut in the treatment of high-risk and senior patients with benign prostatic hyperplasia and bladder stones.Methods A retrospective review was conducted for 68 high-risk and senior patients with benign prostatic byperplasia and bladder stones.All of them were treated by TUPKEP and suprapubic small cut.Results Operation was successfully performed in all 68 cases.And there was no instance of transurethral resection syndrome,shock,myocardial infarct,cerebral infarction,cerebral hemorrhage,permanent urinary incontinence or surgical site infection.Seven patients with temporal urinary incontinence recovered at a mean time of (9.48 ± 1.52) days post-operation.The mean operative duration was (48.63 ±4.14) min and the mean volume of blood loss (50.97 ± 5.33) ml.The changes of maximum flow rate (Qmax),international prostatic symptom score (I-PSS) and quality-of-life (QOL) were statistically significant before and after operation.Qmax increased from (4.56 ± 0.35) to (18.82 ± 1.65)ml/s (P＜0.001),I-PSS decreased form (21.96±1.89) to (11.23±0.86) (P=0.018) and QOL decreased from (4.94±0.35) to (1.95 ±0.32) (P=0.011).Conclusion The approach of TUPKEP and suprapubic small cut is both safe and effective in the treatment of high-risk and senior patient with benign prostatic hyperplasia and bladder stones and should be widely applied.