前列腺增生合并膀胱结石的微创治疗.docVIP

前列腺增生合并膀胱结石的微创治疗 　　作者：何汇海,杨德林,王剑松,徐鸿毅　　作者单位：云南昆明，昆明医学院第二附属医院泌尿外科 　　【摘要】 目的 探讨前列腺增生(BPH)并膀胱结石的有效治疗方法。方法 采用经尿道膀胱镜下气压弹道碎石和等离子体双极电切治疗58例BPH并膀胱结石。结果 手术时间60～170 min，平均95 min,术后3～5 d拔尿管,排尿通畅。无前列腺电切综合征、大出血、膀胱穿孔等并发症。病理结果均为良性前列腺增生。术后随诊3个月IPSS评分由术前平均24.5分降至8分，平均最大尿流率由术前6 mls上升至15.4 mls。结论 该方法是同期处理良性前列腺增生合并膀胱结石的安全有效的治疗方法，具有出血少、创伤小、并发症少、康复快、住院时间短的特点。 　　【关键词】 前列腺增生; 膀胱结石; 等离子体双极电切; 弹道碎石 　　Minimally invasive technique in treatment for benign prostatic hyperplasia complicated with bladder stones 　　HE Hui-hai，YANG De-lin，WANG Jian-song,et al.Department of Urology，the 2nd Affiliated Hospital of Kunming Medical College，Kunming 650101，China 　　[Abstract] Objective To explore an effective treatment for benign prostatic hyperplasia complicated with bladder stones.Methods Using pneumatic lithotripsy and bipolar plasmakinetic technique in 58 cases with bladder stones and benign prostatic hyperplasia.Results The mean time of operation was 95 minutes ranging from 60 to 170 minutes.Urethral catheter was withdrawn in 3～5 days of postoperation and voiding was easy and smooth.None had complications such as transurethral resection syndrome，hemorrhea and vesical perforation.The diagnosis of benign prostatic hyperplasia was confirmed by pathology examination.After 3 months follow-up survey，the average IPSS marks decreased from 24.5 marks before operation to 8 marks after operation and the max flow ratio (MFR) grew from the 6 mls before operation up to 15.4 mls after operation.Conclusion The method is characterized with less bleeding，small wound，less complications，quick recovery and short hospitalization time，which is a safe and effective method for the treatment of senile BPH with vesical calculus. 　　[Key words] prostatic hyperplasia; bladder calculi; bipolar plasmakinetic; pneumatic lithotripsy 　　老年良性前列腺增生(BPH)合并膀胱结石的传统术式为耻骨上膀胱切开取石、前列腺切除术，但这种治疗方法出血多、创伤大、恢复慢、住院时间长，尤其对于全身状况差的高龄患者来说，难以耐受手术风险。随着微创技术的发展，传统术式逐渐被日益进步的腔内技术所取代。2004 年5 月~2008年8月，我们采用经尿道等离子双极电切术(PKRP)联合气压弹道碎石治疗老年前列