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目的探讨高危前列腺增生(BPH)并膀胱结石的治疗方法及疗效。方法用同期治疗方式,32例经尿道采用EMS系统做气压弹碎石及4例经膀胱切开取石后再经尿道行前列腺等离子体双极汽化电切(PKRP)。结果 32例经尿道气压弹碎石手术时间25~120min,平均40min,无膀胱穿孔、泌尿系感染;4例因结石较大,膀胱切开取石手术时间约30min。36例均行PKRP,手术时间30~90min,平均55min,术中出血少,均未输血;32例术后持续膀胱冲洗2~3d,5d拔除尿管,患者排尿通畅;4例膀胱切开者,膀胱冲洗6~7d后拔除造瘘管,2周后拔除尿管,患者排尿通畅。随访3~24个月,术前IPSS评分为24.5分,术后3个月降至8.4分(P<0.05)。结论 PKRP结合EMS系统是治疗高危BPH并膀胱结石的一种安全、有效的治疗方法,但传统的膀胱切开取石手术仍为不可或缺手段。
Objective To investigate the treatment and efficacy of high-risk benign prostatic hyperplasia (BPH) and bladder stones. Methods Thirty-two patients undergoing transurethral resection of the ureter were treated by pneumatic transurethral pneumatic lithotripsy through the urethra and 4 patients underwent transurethral resection of the prostate by bipolar vaporization (PKRP). Results 32 cases of transurethral pneumatic lithotripsy operation time 25 ~ 120min, an average of 40min, no bladder perforation, urinary tract infection; 4 cases of stones due to large, cystectomy surgery time of about 30min. 36 patients underwent PKRP, operation time 30 ~ 90min, an average of 55min, less blood loss, were not transfused; 32 cases of bladder irrigation after 2 ~ 3d, 5d removal of the catheter, patients with voiding smooth; 4 cases of bladder incision , Bladder flushed 6 ~ 7d after removal of fistula, 2 weeks after the removal of the catheter, urinary patency. The follow-up ranged from 3 to 24 months. The preoperative IPSS score was 24.5 and dropped to 8.4 after 3 months (P <0.05). Conclusions PKRP combined with EMS is a safe and effective treatment for high-risk BPH and bladder stones. However, traditional cystolithotomy is still an indispensable means.