【摘要】 目的 探討良性前列腺增生（benign prostatic hyperplasia，BPH）伴膀胱結石的有效腔內治療方法。〖HTH〗方法 2003年6月-2009年12月，使用F26號電切鏡外鞘作為撐開器，氣壓彈道和（或）鈥激光粉碎膀胱結石，經尿道前列腺電切術 （transurethral resection of the prostate，TURP） 治療BPH伴膀胱結石86例。患者年齡58～83歲，平均68.6歲；病程2～8年，平均5.2年。術前患者國際前列腺癥狀評分（international prostate symptom score，IPSS）為（24.6±3.9）分，生活質量（5.7±0.6）分；前列腺重量（46.5±6.8） g，剩余尿量（185±58） mL，最大尿流率（5.7±2.3） mL/s。 結果 86例均一次手術成功。碎石時間為16~58 min，平均38 min；前列腺電切時間40~100 min，平均65 min。術中無并發癥發生。術后 5~8 d拔除尿管，平均6.5 d。術后4 例出現前尿道狹窄，經治療后痊愈。54例獲隨訪，隨訪時間2~6個月，平均3個月。術后2個月，54例最大尿流率升至（18.5±4.1） mL/s，剩余尿量下降至（16±22） mL，IPSS評分下降至（7.8±1.6）分，生活質量（2.5±0.3）分，與術前比較差異均有統計學意義（Plt;0.01）。 結論 經尿道碎石術和TURP一次性治療BPH伴膀胱結石安全、有效、經濟。【Abstract】 Objective To explore an effective endourologic treatment method for benign prostatic hyperplasia (BPH) with bladder calculi. Methods From June 2003 to December 2009, ballistic or holmium laser lithotripsy by outer sheath resectoscope and transurethral resection of the prostate (TURP) were performed on 86 patients with BPH and bladder calculi. The patients aged 58 to 83 years old, averaging at 68.6 years. Duration of their disease course ranged from 2 to 8 years, averaging 5.2 years. Before surgery, the international prostate symptom score (IPSS) was 24.6±3.9; the score of quality of life (QOL) was 5.7±0.6; prostatic weight was (46.5±6.8) g; residual urine (RU) volume was (185±58) mL; and the peak urine flow rate (Qmax) was (5.7±2.3) mL/s. Results The operations were completed successfully in all cases with a mean lithotripsy time of 38 min (16-58 minutes) and a mean TURP time of 65 min (40-100 minutes). No complications occurred during the operation. Urethral catheter was withdrawn 5-8 days after operation, with a mean period of 6.5 days. Four patients had anterior urethral stricture after operation, but recovered through treatment. Fifty-four patients were followed up for 2 to 6 months with an average follow-up time of 3 months. Two months after the operations, IPSS decreased to 7.8±1.6; Qmax increased to (18.5±4.1) mL/s; RU decreased to (16±22) mL and QOL was 2.5±0.3. Compared with preoperative conditions, the differences were all statistically significant (P＜0. 01). Conclusion Transurethral lithotripsy combined with TURP is an effective, safe and economical treatment for benign prostatic hyperplasia with bladder calculi.
機械應力幾乎調節了細胞的所有功能，探討其如何發揮生物效應關鍵在于研究細胞對機械應力的感知及其信號轉導機制。該文從細胞外基質、細胞膜、細胞骨架及細胞核等幾個方面著手，詳述了細胞對機械應力的感知及其轉導機制。機械應力被細胞感知及轉導主要有 2 個途徑，一個是力的直接傳遞，另一個是機械信號轉換為化學信號。該文旨在為研究機械應力相關疾病的精準治療及機械應力的優化構建組織工程器官等方面提供一定參考。