【摘要】 目的研究两种微创取石方案对膀胱多发结石合并BPH老年患者围手术期临床指标及安全性的影响。方法选取2016年1月至2017年12月在青海红十字医院治疗的140例膀胱多发结石合并BPH老年患者作为研究对象。用随机数表法分为对照组和观察组,每组各70例,对照组给予TUVP联合气压弹道碎石治疗,观察组给予TUVP联合钬激光碎石术治疗。比较两组患者的围手术期临床指标、临床疗效和并发症情况等。结果观察组取石时间、手术时间、术中出血量和膀胱冲洗时间少于对照组,差异具有统计学意义(P<0.05),两组患者的导尿管置管时间和住院时间相近,差异无统计学意(P>0.05)。观察组IPSS评分、QOL评分和RUV低于对照组,Qmax高于对照组,差异具有统计学意(P<0.05)。两组患者的并发症发生率和结石排尽率相近,差异无统计学意(P>0.05)。结论 TUVP联合钬激光碎石术治疗膀胱多发结石合并BPH老年患者的效果显著,和TUVP联合气压弹道碎石术相比,能够明显改善患者的围手术期临床指标和术后疗效,两者安全性均较好,值得在临床推广应用。更多还原

【Abstract】 Objective To study the effect of two minimally invasive lithotripsy schemes on the perioperative clinical parameters and safety of elderly patients with multiple bladder stones and benign prostate hyperplasia(BPH). Methods 140 elderly patients with multiple bladder stones and BPH treated from January 2016 to December 2017 in our hospital were selected and divided randomly into the control group and the observation group. The control group was treated with transurethral electro-vaporization(TUVP) combined with pneumatic lithotripsy, while the observation group was treated with TUVP combined with holmium laser lithotripsy. The perioperative clinical indicators, clinical efficacy and complications of the two groups were compared. Results The time of stone removal, operation time, intraoperative bleeding and bladder irrigation in the observation group were shorter/less than those in the control group, with statistically significant differences(P<0.05). The time of catheterization and hospitalization in the two groups were similar(P>0.05). The international prostate symptom score(IPSS) score, quality of life(QOL) score and residual urine volume(RUV) of the observation group were lower than those of the control group, and the Qmax was higher than that of the control group, with statistically significant differences(P<0.05). The incidence of complications and stone excretion rate in the two groups were similar, with no statistically significant difference(P>0.05). Conclusions TUVP combined with holmium laser lithotripsy is effective in the treatment of elderly patients with multiple bladder stones complicated with BPH. Compared with TUVP combined with pneumatic ballistic lithotripsy, it can significantly improve the perioperative clinical indicators and post-operative efficacy of patients, though both of them are safe and worthy of clinical application.更多还原