目的:探讨经尿道前列腺电气化术联合钬激光碎石术治疗前列腺增生合并膀胱结石患者的临床疗效.方法:选取2014年10月至2016年3月收治的60例前列腺增生合并膀胱结石患者作为研究对象,均行经尿道前列腺电切术(TURP)联合钬激光碎石术治疗,观察治疗效果.结果:本组60例患者均一次手术成功,手术平均时间(86.3 ±9.6) min,其中TURP术时间40 ～ 95 min,钬激光碎石术时间10 ～ 36min.术中平均出血量(115.3±16.8) mL,未见TURP综合征、膀胱穿孔及严重感染等并发症.术后仅出现1例暂时性尿失禁,经提肛训练后恢复正常,术后平均住院时间(7.2±0.6)d,术后复查B超膀胱结石清除率100％,术后随访3～18个月,平均PVR降低至(19.3±1.6)mL,平均MRF上升至(15.8 ±3.2) mL/s,平均QOL降低至(2.0±0.3)分,平均IPSS降低至(8.0±1.2)分,术前后上述指标比较差异均有统计学意义(P＜0.05).结论:TURP联合钬激光碎石术治疗前列腺增生合并膀胱结石疗效显著,安全性好,值得在临床上推广应用.%Objectives:To investigate the clinical efficacy of transurethral resection of prostate combined with hohnium laser lithotripsy in the treatment of benign prostatic hyperplasia complicated with bladder stones.Methods:The 60 patients with benign prostatic hyperplasia complicated with bladder stones in our hospital from October 2014 to March 2016 were selected.All the patients were treated with transurethral resection of prostate (TURP) combined with holmium laser lithotripsy.The treatment effect was observed.Results:All the 60 patients were successfully operated.The mean operation time was (86.3 ± 9.6) min,including the TURP of 40 ～95min and holmium laser lithotripsy time of 10 ～36min.The mean intraoperative blood loss were (115.3 ± 16.8) ml.No complications were found such as TURP syndrome,bladder perforation and severe infection.After operation,only 1 case had temporary incontinence,and it returned to normal after exercising levator ani muscle.The average postoperative hospitalization time was (7.2 ± 0.6) d,and after surgery,the removal rate of bladder stone was 100％.After 3 ～ 18 month follow-up,the average PVR was reduced to (19.3 ± 1.6) ml,the average MRF was increased to (15.8 ± 3.2) ml/s,the average QOL was reduced to (2.0 ± 0.3) points,and the average IPSS was reduced to (8.0 ± 1.2) points,all with statistically significant difference compared with those before treatment (P ＜ 0.05).Conclusion:TURP combined with holmium laser lithotripsy is of remarkable effect in treating patients with benign prostatic hyperplasia complicated with bladder stones,which is worthy to be popularized in clinical application.
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