摘要
目的分析评价经尿道前列腺电切术(TURP)联合膀胱造瘘术治疗高危高龄大体积良性前列腺增生症(BPH)的安全性和有效性。方法回顾性分析158例经TURP联合膀胱造瘘术治疗后的高危高龄大体积(>80ml)BPH患者(实验组)和145例经TURP联合膀胱造瘘术治疗后的高危高龄非大体积(≤80ml)BPH患者(对照组)的临床资料,分析患者手术时间、术中出血量、国际前列腺症状评分(IPSS)、最大尿流率(Qmax)和残余尿量(RUV)。结果实验组158例患者均顺利完成手术,平均手术时间(84±26)min,术中出血量平均约(99±28)ml。术后12个月随访,IPSS由(30±4)分下降至(7±3)分,Qmax由(7.0±4.5)ml/s增至(20.0±6.0)ml/s,RUV由(158.6±82.9)ml降至(20.2±8.6)ml。治疗前后的IPSS、Qmax、RUV对比,P<0.05,差异有统计学意义。对照组145例患者均顺利完成手术,手术时间(50±15)min,术中出血量平均约(61±19)ml。术后12个月随访,IPSS由(28±3)分下降至(8±3)分,Qmax由(8.1±5.1)ml/s增至(22.6±4.3)ml/s,RUV由(147.1±85.7)ml降至(15.4±9.5)ml,治疗前后的IPSS、Qmax、RUV对比,P<0.05,差异有统计学意义。两组治疗效果的组间比较,P>0.05,差异无统计学意义。结论对高危高龄大体积BPH患者应用TURP联合膀胱造瘘术安全有效,充分的术前准备、个体化的手术方案和规范的手术后健康教育是治疗成功的关键。
Objective analyze and evaluate the safety and efficacy of using combination regimen of transurethra] resection of prostate（TURP） and cystostomy treating high-risk elderly large volume benign prostatic hyperplasia （BPH）. Methods A retrospective analysis of the clinic data after TURP and cystostomy treatment of 158 high-risk elderly large volume （〉80ml） BPH patients （experimental group） and 145 high-risk elderly not large volume （≤ 80ml） BPH patients （control group）, and recording and analyzing the operation time, blood loss, the international prostate symptom score（IPSS）, maximum flow rate（Qmax） and residual urine volume （RUV）. Results 158 cases of the experimental group patients were successfully operated,the average operation time 84± 26min,the average blood loss of about 99±28ml. After 12 months of follow-up, IPSS decreased from 30±4 to 7±3points, Qmax by a 7.0±4.5m]/s increased to 20.0±6.0ml/s,RUV by a 158.6±82.9ml reduced to 20.2±8.6ml. Before and after treatment IPSS,Qmax, RUV contrast,P〈0.05, the difference was statistically significant. 145 cases of the control group patients were successfully operated,operation time 50±15min,the average blood loss of about 61＋19ml. After 12 months of follow-up,IPSS decreased from 28±3 to 8±3 points,Qmax by a 8.1±5.1ml/s increased to 22.6±4.3ml/s,RUV by a 147.1±85.7ml fell to 15.4±9.Sml,treatment before and after the IPSS, Qmax, RUV contrast ,P〈0.05 ,the difference was statistically significant. Between the two groups of treatment group, P〉0.05, the difference was not statistically significant. Conclusion Combination regimen of TURP and cystostomy is safe and effective for high-risk elderly large volume patients with BPH, adequate preoperative preparation,individualized surgical plan and health education after standard surgery are the keys to successful treatment.
作者
张义木
曾令浩
白海涛
ZHANG Yimu ZENC Linghao BAl Haitao(Department of Urology,People＇s Hospital of Macheng City ,Hubei Province ,438300, Chin)
出处
《江西医药》
CAS
2017年第4期293-295,299,共4页
Jiangxi Medical Journal
