CAJ | 학술논문

目的：探讨微创治疗良性前列腺增生并膀胱结石的最佳方法。方法选择127例良性前列腺增生合并膀胱结石的患者，分别采用大力碎石钳碎石加经尿道前列腺电切术（ TURP）（ A组，45例）、经膀胱镜钬激光碎石加TURP术（ B组，42例）、小切口开放取石加TURP术（ C组，40例）治疗。观察三组一期手术成功率，碎石、取石时间、住院时间、出现膀胱黏膜损伤和膀胱穿孔改开放手术的例数。结果 B组碎石取石时间显著长于A组、C组，但是住院时间明显短于A组和C组。在B组中，术中发生膀胱或前列腺损伤共为3例，损伤率显著小于A组（12例）（χ2＝5.632， P ＝0.023）。B组因膀胱穿孔或结石无法粉碎改为开放手术率为0，A组为20.0％，B组明显低于A组，差异有显著性（χ2＝13.642，P ＜0.001）。结论钬激光碎石结合TURP治疗前列腺增生合并膀胱结石具有损伤小、疗效好、恢复快等优点，虽碎石取石时间延长，但手术并发症少，值得临床推广。
목적：탐토미창치료량성전렬선증생병방광결석적최가방법。방법선택127례량성전렬선증생합병방광결석적환자，분별채용대력쇄석겸쇄석가경뇨도전렬선전절술（ TURP）（ A조，45례）、경방광경화격광쇄석가TURP술（ B조，42례）、소절구개방취석가TURP술（ C조，40례）치료。관찰삼조일기수술성공솔，쇄석、취석시간、주원시간、출현방광점막손상화방광천공개개방수술적례수。결과 B조쇄석취석시간현저장우A조、C조，단시주원시간명현단우A조화C조。재B조중，술중발생방광혹전렬선손상공위3례，손상솔현저소우A조（12례）（χ2＝5.632， P ＝0.023）。B조인방광천공혹결석무법분쇄개위개방수술솔위0，A조위20.0％，B조명현저우A조，차이유현저성（χ2＝13.642，P ＜0.001）。결론화격광쇄석결합TURP치료전렬선증생합병방광결석구유손상소、료효호、회복쾌등우점，수쇄석취석시간연장，단수술병발증소，치득림상추엄。
Objective To investigate the best minimally method in treating benign prostatic proliferate and bladder calculi. Methods 127 cases of benign prostatic hyperplasia and bladder stones were collected into this study. Gravel pliers plus transurethral resection( TURP)sur-gery were used in A group(45 cases),holmium laser lithotripsy by cystoscopy plus TURP surgery were performed in group B(42 patients). And a small incision open surgery plus TURP in group C(40 patients)were taken. Major surgical results were compared in the three groups. Results In Group B,lithotripsy was significantly higher in group A and group C,but the length of hospital stay was significantly less than in group A and group C. In Group B. The total three cases had injury in the bladder or prostate surgery,with the damage significantly less than that in group A(12 cases)(χ2 =5. 632,P =0. 023). In group B,rates of change to open surgery due to bladder perforation or crushed stone were 0. 00%,but it was up to 20. 0% in group A,with significant differences between the two groups(χ2 =13. 642,P <0. 001). Conclusion Holmium laser litho-tripsy combined with TURP for benign prostatic hyperplasia and bladder stones have a small injury,efficacy,quick recovery. Although this method is prolonged,this method have fewer surgical complications,which is worthy of promotion.