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目的探讨经尿道超脉冲等离子电切(TUSPPK)联合超声碎石(USL)治疗高危前列腺增生(BPH)合并膀胱结石的临床疗效及安全性。方法采用TUSPPK联合USL治疗高危BPH合并膀胱结石患者32例,比较手术前及术后3个月国际前列腺症状评分(IPSS)、生活质量评分(QOL)、剩余尿量及尿流率等指标。结果 32例患者均顺利完成手术。手术时间(72.5±8.7)min,结石取尽率100%。术后留置导尿管时间(5.2±1.3)d。IPSS和QOL评分分别由术前的(26.4±5.5)分及(5.3±0.7)分下降至(10.1±2.6)分及(2.5±0.5)分,最大尿流率由术前(6.5±2.3)ml/s增加至(13.8±3.1)ml/s,剩余尿量由术前(162.5±22.8)ml下降至(38.2±7.1)ml(P<0.05)。无严重并发症。结论 TUSPPK联合USL治疗高危BPH合并膀胱结石具有损伤小、结石清除率高、并发症少的优点。
Objective To investigate the clinical efficacy and safety of transurethral ultrasonography (TUSPPK) combined with ultrasonic lithotripsy (USL) in the treatment of high-risk benign prostatic hyperplasia (BPH) complicated with bladder stones. Methods TUSPPK and USL were used in the treatment of 32 patients with high-risk BPH and bladder stones. The scores of IPSS, QOL, residual urine volume and urinary flow were compared before and 3 months after operation. Results 32 patients completed the operation successfully. Surgery time (72.5 ± 8.7) min, stone exhaustion rate of 100%. Postoperative indwelling catheter time (5.2 ± 1.3) d. The IPSS and QOL scores decreased from (26.4 ± 5.5) and (5.3 ± 0.7) to (10.1 ± 2.6) and (2.5 ± 0.5) ml / s to (13.8 ± 3.1) ml / s, and the residual urine volume decreased from (162.5 ± 22.8) ml to (38.2 ± 7.1) ml before operation (P <0.05). No serious complications. Conclusion The combination of TUSPPK and USL in the treatment of high-risk BPH with bladder stones has the advantages of less damage, high stone clearance rate and fewer complications.