摘要
目的观察经尿道柱状水囊前列腺扩开术(TUSP)对良性前列腺增生的尿流动力学、性功能及生命质量的影响。方法前瞻性纳入2017年1月至2019年6月浙江省德清县人民医院收治的80例良性前列腺增生患者作为研究对象,按随机数字表法分为A、B两组各40例,A组采用TUSP治疗,B组应用经尿道等离子双极电切术(TUPKP)治疗,比较两组手术时间、术中出血量、膀胱冲洗时间、尿管留置时间、住院时间,评估手术效果,测定手术前后两组血红蛋白(Hb)、血钠(Na)、残余尿量(PVR)、最大尿流率(Qmax)、国际前列腺症状评分(IPSS)及国际勃起功能障碍评分(IIEF-5)、生命质量指数(QOL)的变化,统计手术并发症。结果A组手术时间、膀胱冲洗时间、尿管留置时间、住院时间及术中出血量均少于B组[(15.63±4.17)min比(58.79±10.45)min、(6.26±1.17)h比(45.51±10.03)h、(3.07±0.68)d比(5.67±1.51)d、(3.63±0.43)d比(6.08±1.72)d、(18.32±2.79)ml比(65.26±20.64)ml](P<0.01);两组手术疗效等级及术后1 d Na比较差异无统计学意义(P>0.05);术后1 d,A组Hb高于B组[(115.63±9.78)g/L比(109.65±8.36)g/L](P<0.01);术后3、6个月两组PVR、Qmax、IPSS、IIEF-5、QOL均较术前改善(P<0.01),但组间比较差异无统计学意义(P>0.05);A组总并发症发生率低于B组[10.00%(4/40)比27.50%(11/40)](P<0.05)。结论TUSP与TUPKP治疗良性前列腺增生疗效相当,均可改善前列腺增生症状,提升生命质量,改善性功能;但TUSP术中出血少,手术时间短,术后恢复速度快,并发症少,安全性更高。
Objective To observe the effects of transurethral split of the prostate(TUSP)on the urodynamics,the sexual function and the quality of life of benign prostatic hyperplasia.Methods Eighty patients with benign prostatic hyperplasia admitted to the Deqing People′s Hospital of Zhejiang Province from January 2017 to June 2019 were enrolled into the research objects prospectively.According to the random digits table method,they were divided into group A and group B,with 40 cases in each group.The group A was treated with TUSP,while the group B was treated with bipolar transurethral plasma kinetic prostatectomy(TUPKP).The operation time,intraoperative blood loss,bladder irrigation time,urinary catheter indwelling time,hospitalization time of the two groups were compared and surgical effects were evaluated.The changes of hemoglobin(Hb),serum sodium(Na),post-void residual volume(PVR),maximum urinary flow rate(Qmax),international prostate symptom score(IPSS)and international index of erectile function score(IIEF-5),the quality of life index(QOL)of 2 groups before and after the operation were measured.Surgical complications were recorded.Results The operation time,bladder irrigation time,urinary catheter indwelling time and hospital stay in group A were all shorter than that in group B:(15.63±4.17)min vs.(58.79±10.45)min,(6.26±1.17)h vs.(45.51±10.03)h,(3.07±0.68)d vs.(5.67±1.51)d,(3.63±0.43)d vs.(6.08±1.72)d,(18.32±2.79)ml vs.(65.26±20.64)ml,and there were statistical differences(P<0.05);there were no statistical difference between 2 groups in surgical curative effect grade and Na 1 d after operation(P>0.05);1 day after operation,Hb in group A was higher than that in group B:(115.63±9.78)g/L vs.(109.65±8.36)g/L,and there was statistical difference(P<0.05);PVR,Qmax,IPSS,IIEF-5 and QOL 3 and 6 months after surgery were improved in 2 groups(P<0.05),but the difference between 2 groups was not statistically significant(P>0.05);the total complication rate in group A was lower than that in group B:10.00%(4/40)vs.27.5
作者
吴玉平
陈虹璋
张志根
Wu Yuping;Chen Hongzhang;Zhang Zhigen(Department of Urology Surgery,Deqing People′s Hospital,Zhejiang Huzhou 313299,China;Departmetnt of Urology Surgery,Shao Yifu Hospital Affiliated to Zhejiang University School of Medicine,Hangzhou 310020,China)
出处
《中国医师进修杂志》
2021年第5期391-397,共7页
Chinese Journal of Postgraduates of Medicine
