经尿道柱状水囊前列腺扩开术治疗高危良性前列腺增生患者的临床效果

Clinical effect of transurethral columnar balloon dilation of prostate in treatment of patients with high risk of benign prostatic hyperplasia

目的观察经尿道柱状水囊前列腺扩开术治疗高危良性前列腺增生的临床效果。方法将126例高危良性前列腺增生患者随机分为观察组与对照组,各63例。对照组采用经尿道前列腺等离子双极电切术治疗,观察组采用经尿道柱状水囊前列腺扩开术治疗。比较两组患者手术时间、术中出血量、膀胱冲洗时间、留置尿管时间、术后住院时间及术后并发症发生率、术前及术后1个月的国际前列腺症状评分(IPSS)和最大尿流率及膀胱残余尿量,以及术前及术后1 d的血清P物质、前列腺素E 2(PGE 2)、5-羟色胺、白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子α(TNF-α)水平。结果观察组的手术时间、术中出血量、术后膀胱冲洗时间、留置尿管时间、术后住院时间及术后并发症发生率均短于或低于对照组(均P<0.05);观察组患者术后1个月的IPSS量表评分、膀胱残余尿量,以及术后1 d的血清P物质、PGE 2、5-羟色胺、IL-6、hs-CRP及TNF-α水平均低于对照组,而术后1个月的最大尿流率高于对照组(均P<0.05)。结论采用经尿道柱状水囊前列腺扩开术治疗高危良性前列腺增生,能够显著改善患者的下尿路症状,减少患者血清炎症因子的表达及疼痛介质的分泌,对患者创伤更小,术后恢复更快。

Objective To observe the clinical effect of transurethral columnar balloon dilation of the prostate in the treatment of patients with high risk of benign prostatic hyperplasia.Methods A total of 126 patients with high risk of benign prostatic hyperplasia were randomly divided into observation group and control group,with 63 cases in each group.The control group was treated with transurethral plasma bipolar prostatectomy,and the observation group was treated with transurethral columnar balloon dilation of the prostate.Operation time,intraoperative blood loss,bladder irrigation time,catheter indwelling time,postoperative hospital stay,and incidence rate of postoperative complications,the International Prostate Symptom Score(IPSS),maximum urinary flow rate and bladder residual urine volume before and one month after operation,as well as serum levels of substance P,prostaglandin E 2(PGE 2),5-hydroxytryptamine,interleukin 6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor α(TNF-α)before and one day after operation were compared between the two groups.Results The observation group exhibited shorter operation time,less intraoperative blood loss,shorter postoperative bladder irrigation time,catheter indwelling time and postoperative hospital stay,and lower incidence rate of postoperative complications than the control group(all P<0.05);compared with the control group,the observation group obtained lower postoperative 1-month IPSS scale score and bladder residual urine volume,as well as lower serum levels of substance P,PGE 2,5-hydroxytryptamine,IL-6,hs-CRP and TNF-αon day 1 postoperatively,whereas presented higher maximum urinary flow rate one month after operation(all P<005).Conclusion Transurethral columnar balloon dilation of the prostate can remarkably improve lower urinary tract symptoms,reduce serum inflammatory factors expression and the secretion of pain mediators,cause minor trauma,and achieve postoperative recovery more rapidly in the treatment of patients with high risk of benign prostatic hyperplasia.