超选择性前列腺动脉栓塞术治疗高龄大体积前列腺增生研究

A small-sample clinical pairing study of super-selective prostate artery embolization with transurethral plasmakinetic enucleation of the prostate for the treatment of senior and high-risk large-volume benign prostatic hyperplasia

目的:对比前列腺动脉栓塞术(PAE)与经尿道等离子前列腺剜除术(TUPKEP)治疗高龄老年前列腺增生的临床疗效。方法:回顾性分析2017年12月至2020年12月民航总医院泌尿外科50例BPH患者,根据手术方法不同,分为PAE组和TUPKEP组,每组25例。比较两组患者尿痛评分、最大尿流率(Qmax)、残余尿量(RUV)、IPSS评分、QOL评分和术中及术后并发症。结果:随访1月和3月时,PAE组相比TUPKEP组尿痛数字评分优[(1.56±0.82)vs.(3.72±0.89)分;(1.04±0.84)vs.(1.72±1.10)分],Qmax[(10.60±1.63)vs.(19.74±2.37)ml/s;(13.99±1.43)vs.(21.38±3.13)ml/s]、RUV[(78.28±4.49)vs.(21.16±7.00)ml;(58.28±4.48)vs.(20.16±7.00)ml]差,差异具有统计学意义(P<0.05),IPSS评分、QOL评分无差异(P>0.05);随访6月时,PAE组相比TUPKEP组Qmax[(14.49±1.43)vs.(23.13±3.40)ml/s]、RUV[(57.28±4.49)vs.(19.56±5.87)ml]差,差异具有统计学意义(P<0.05),NRS评分、IPSS评分、QOL评分无差异(P>0.05)。PAE组术后并发症有4例(16%),TUPKEP组术后并发症11例(44%),两组患者并发症差异具有统计学意义(χ^(2)=4.667,P=0.031)。结论:PAE对于高龄合并多种内科疾病的老年男性安全有效。

Objective:To compare the clinical effects of prostatic artery embolization(PAE)and transurethral plasmakinetic enucleation of the prostate(TUPKEP)in the treatment of benign prostatic hyperplasia in the elderly.Methods:From December 2017 to December 2020,50 patients with BPH in the Department of Urology of Civil Aviation General Hospital were retrospectively analyzed.According to different surgical methods,they were divided into PAE group and TUPKEP group,with 25 patients in each group.Urinary pain score,the maximum flow rate(Qmax),residual urine volume(RUV),IPSS score,QOL score and intraoperative and postoperative complications were compared between the two groups.Results:At 1 and 3 months of follow-up,the PAE group had better number scores of urinary pain than TUPKEP group[(1.56±0.82)vs.(3.72±0.89);(1.04±0.84)vs.(1.72±1.10)],Qmax[(10.60±1.63)vs.(19.74±2.37)ml/s;(13.99±1.43)vs.(21.38±3.13)ml/s],RUV[(78.28±4.49)vs.(21.16±7.00)ml;(58.28±4.48)vs.(20.16±7.00)ml],the difference was statistically significant(P<0.05),but there was no difference in IPSS score and QOL score(P>0.05).At 6-month follow-up,Qmax[(14.49±1.43)vs.(23.13±3.40)ml/s]and RUV[(57.28±4.49)vs.(19.56±5.87)ml]in PAE group compared with TUPKEP group was significantly different(P<0.05).There were no differences in NRS,IPSS and QOL scores(P>0.05).There were 4(16%)postoperative complications in PAE group and 11(44%)in TUPKEP group.The difference between the two groups was statistically significant(χ^(2)=4.667,P=0.031).Conclusion:PAE is safe and effective for elderly men with multiple medical diseases.