等离子电切联合球囊扩张导管治疗男性尿道狭窄的效果

Effect of plasma electroresection combined with balloon dilated catheter on male urethral stenosis

目的探讨等离子电切联合球囊扩张导管治疗男性尿道狭窄的效果。方法选择火箭军特色医学中心2019-01至2021-06收治的80例尿道狭窄男性患者,采用随机数字表法随机分组为试验组和对照组,各40例。试验组采用等离子电切联合球囊扩张导管筋膜扩张器治疗,对照组采用单纯球囊扩张手术治疗。统计分析试验组和对照组患者手术用时、下床活动时间、手术出血量、尿管留置时间、住院时间、手术前后的尿动力学参数指标、国际前列腺症状评分(IPSS)、生活质量评分(QOL)及手术并发症。结果试验组和对照组的下床活动时间、尿管留置时间、住院时间差异不具有统计学意义;试验组的手术用时、手术出血量长于或多于对照组(P<0.05)。术前,试验组和对照组的残余尿量、最大尿流率、平均尿流率差异不具有统计学意义;术后,试验组的最大尿流率[(23.40±1.91)ml/s]、平均尿流率[(20.10±2.19)ml/s]均高于对照组[(20.10±2.19)ml/s]、[(17.57±2.18)ml/s](P<0.05),试验组的残余尿量[(9.27±5.51)ml]低于对照组[(16.87±8.53)ml](P<0.05)。术后,试验组的IPSS评分[(7.15±1.16)分]及QOL评分[(0.30±0.46)分]均低于对照组[(9.87±1.93)分、(0.72±0.78)分](P<0.05)。术后,试验组的手术并发症发生率(15.0%)与对照组(7.50%)比较差异无统计学意义。结论等离子电切联合球囊扩张导管治疗男性患者尿道狭窄能够更显著地缓解患者的临床症状及改善尿动力学指标。

Objective To investigate the effect of plasma electroresection combined with balloon catheter in the treatment of male urethral stricture.Methods Eighty male patients with urethral stricture admitted to Characteristics Medical Center of Chinese PLA Rocket Force from January 2019 to June 2021 were divided into experimental group and control group with 40 patients in each group by random number table method.The experimental group was treated with plasma electroresection combined with balloon catheter fascia expander,and the control group was treated with simple balloon dilation.The following data were statistically analyzed,the operation time,time of getting out of bed,amount of bleeding during the operation,retention time of urinary tube,hospitalization time,urodynamic parameters before and after the operation,international Prostate Symptom Score(IPSS),Quality of Life Score(QOL)and surgical complications of patients in the experimental group and the control group.Results There was no significant difference between the experimental group and the control group in the time of getting out of bed,indwelling catheter and hospitalization.The operation time and blood loss in the experimental group were higher than those in the control group(P<0.05).Before operation,there was no significant difference in residual urine volume,maximum urinary flow rate and average urinary flow rate between the experimental group and the control group(P>0.05).After operation,the maximum urinary flow rate[(23.40±1.91)ml/s]and average urinary flow rate[(20.10±2.19)ml/s]in the experimental group were higher than those in the control group[(20.10±2.19)ml/s]and[(17.57±2.18)ml/s](P<0.05).The residual urine volume[(9.27±5.51)ml]in the experimental group was lower than that in the control group[(16.87±8.53)ml](P<0.05).After operation,the IPSS score[(7.15±1.16)points]and QOL score[(0.30±0.46)points]in the experimental group were lower than those in the control group[(9.87±1.93)points]and[(0.72±0.78)points](P<0.05).After operation,the operative complication rate in the experimental group was 15.0%,which was not significantly different from that in the control group 7.50%.Conclusions Plasma electroresection combined with balloon dilatation catheter in the treatment of male urethral stricture can significantly improve the clinical symptoms and urodynamic parameters of patients.