摘要
目的探讨逼尿肌活力低下(DU)对良性前列腺梗阻(BPO)患者经尿道前列腺切除术(TURP)疗效的影响。方法回顾性分析2013年1月至2016年12月接受TURP治疗的157例BPO患者的临床资料。年龄48~86岁,平均70岁。所有患者均行尿动力学检查,膀胱收缩力指数(BCI)49.3~208.6,平均120.1。根据BCI值将患者分为两组:DU组(BCI〈100)47例,非DU组(BCI≥100)110例。/}15组和非DU组患者术前国际前列腺症状评分(Ipss)[(21.5±7.0)与(21.5±6.2)]、储尿期症状评分(IPSS—S)[(9.5±3.6)与(9.8±3.5)]、排尿期症状评分(IPSS-V)[(12.0±4.9)与(11。8±4.2)]、生活质量评分(QOL)[(5.1±0.8)与(5.3±0.7)]、最大自由尿流率(fQmax)[(6.5±3.5)ml/s与(7.6±5.0)m]/s]、残余尿量(PVR)[(137.4±146.2)ml与(105.2±135.9)m1]组间比较差异无统计学意义(P〉0.05)。术后3个月随访上述指标,将IPSS、IPSS—S、IPSS—V改善成功定义为术后/术前≤0.50,QOL改善成功定义为术前一术后≥3,fQmax改善成功定义为术后-术前≥5.0m]/s。比较两组患者上述指标改善程度及改善成功率。根据ROC曲线,将DU患者分为轻度DU组、重度DU组,比较两组相关指标改善成功率。结果DU组和非DU组术后IPSS[(8.6±7.3)与(4.4±4.5)]、IPSS—S[(5.0±3.5)与(3.6±2.8)]、IPSS—V[(3.6±5.1)与(0.9±2.3)]、QOL[(2.3±1.5)与(1.5±1.0)]、fQmax[(11.5±6.9)ml/s与(16.3±6.9)ml/s]、PVR[(48.4±65.6)ml与(23.6±25.6)m1]组间比较差异有统计学意义(P〈0.05),且两组分别与术前比较差异均有统计学意义(P〈0.05)相比差异均有统计学意义(P〈0.05),且组间比较差异有统计学意义(P〈0.05);两组的IPSS、IPSS—S、IPSS—V、QOL、fQmax改善成�
Objective To analyze the impact of detrusor underactivity (DU) on the outcomes of transurethral resection of prostate (TURP) in patients with benign prostatic obstruction (BPO). Methods A retrospective study was conducted in 157 BPO patients who underwent TURP from January 2013 to December 2016. Their ages ranged from 48 to 86 years with a mean age of 70 years. All patients underwent urodynamic study before surgery, bladder contraction index (BCI) ranged from 49.3 to 208.6, with a mean of 120. 1. The patients were divided into two groups according to BCI. DU group (BCI 〈 100 ) consisted of 47 patients, non-DU group (BCI i〉 100) 110patients. Before surgery, there were no significant differences in International Prostate Symptom Score ( IPSS ) , storage and voiding symptom scores of IPSS (IPSS-S, IPSS-V) , quality of life(QOL) , maximum free flow rate (fQmox) ,post-voided residual urine volume (PVR) between the two groups[(21.5±7.0)vs. (21.5±6.2),(9.5±3.6)vs. (9.8±3.5),(12.0± 4.9)vs.(11.8±4.2),(5.1±0.8)vs. (5.3-0.7),(6.5±3.5)ml/s vs. (7.6±5.0)ml/s,(137.4± 146. 2) ml vs. ( 105.2 ± 135.9) ml ] ( P 〉 O. 05 for each). The outcomes of TURP were assessed by the above mentioned parameters at 3 months postoperatively;IPSS,IPSS-S,IPSS-V were regarded as successful if they improved more than 50% , QOL was successful if it was improved more than 3, fQ successful if it was improved 5ml/s. The change and successful improvement rates of the above mentioned parameters were compared between DU and non-DU group. Through receiver operating characteristic curve(ROC) analysis , patients were categorized into mild DU and severe DU group and compared the successful improvement rates between the two groups. Results Both DU group and non-DU group improved significantly in IPSS,IPSS-S, IPSS-V, QOL, fQmax, PVR at 3 months postoperatively (P 〈 0. 05 )and the two groups differed significantly in those parameters [(8.6-7
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2017年第11期815-819,共5页
Chinese Journal of Urology