摘要目的 研究经皮肾镜下钬激光碎石术联合前列腺电切(transurethral under resection prostate percutaneous TURP)与切开取石对老年患者的影响.方法 选择2017年2月至2018年10月本院收治的BPH合并膀胱结石患者156例为观察对象.根据随机数字表法分为观察组与对照组,各78例.观察组给予经皮肾镜下钬激光碎石术联合TURP治疗,对照组给予TURP联合切开取石,对比两组手术指标以及两组性功能相关指标.结果 观察组手术时间(0.43±0.18)h、术中出血量(128.39±21.37) ml、冲洗时间(44.91±5.83)h,均分别明显少于对照组,切除比例(75.66±2.37)％,明显高于对照组,差异有统计学意义(均P＜ 0.05).两组术后国际前列腺评分(International Prostate Score,IPSS)及残余尿量(Residual urine volume,RUV)水平均分别明显低于术前,但术后观察组RUV(13.38±4.19) ml,明显低于对照组,而IPSS为(16.27±3.12)分,高于对照组.两组术后最大尿流率(Qmax)水平明显高于术前,且观察组术后Qmax为(17.84±2.51) ml/s,明显高于对照组的(14.25±3.12)ml/s.结论 经皮肾镜下钬激光碎石术联合前列腺电切术对于老年患者的整体效果较好,有利于患者的康复预后.

abstractsObjective To study the effects of percutaneous holmium laser lithotripsy combined with transurethral resection of prostate (TURP) versus lithotomy for elderly patients.Methods 156 patients with BPH and bladder stones admitted to our hospital from February,2017 to October,2018 were selected as observation objects.According to the method of random number table,they were divided into an observation group and a control group,78 for each group.The observation group was treated with holmium laser lithotripsy under percutaneous nephroscopy and TURP,and the control group with TURP and lithotomy.The surgical parameters and sexual function related indicators were compared between the two groups.Results The operation time,intraoperative bleeding volume,and rinsing time were (0.43±0.18) h,(128.39±21.37) ml,and (44.91±5.83) h in the observation group,which were significantly shorter than those in the control group (all P ＜ 0.05);and the resection ratio was (75.66±2.37)％ in the observation group,which was significantly higher than that in the control group (P ＜ 0.05).The international prostate score (IPSS) and residual urine volume (RUV) were significantly lower after than before the operation in the two groups,but the RUV [(13.38±4.19) ml] in the observation group after operation was significantly lower than that in the control group,while the IPSS [(16.27±3.12)] was significantly higher (P ＜ 0.05).The Qmax levels in the two groups were significantly higher after than before the operation group,and that in the observation group was significantly higher than that in the control group [(17.84±2.51) ml/s vs.(14.25±3.12) ml/s].Conclusion Percutaneous nephrolithotomy combined with holmium laser lithotripsy and transurethral resection of the prostate has a better overall effect on elderly patients,and is conducive to the patients' rehabilitation and prognosis.