经尿道前列腺电切术联合坦索罗辛治疗良性前列腺增生临床效果观察及影响因素分析

Clinical effect of transurethral resection of prostate combined with tamsulosin in the treatment of benign prostatic hyperplasia and analysis of its influencing factors

目的观察经尿道前列腺电切术(TURP)联合坦索罗辛治疗良性前列腺增生(BPH)的临床效果,并对其影响因素进行分析。方法选取咸阳市中心医院自2015年3月至2018年12月收治的128例BPH患者为研究对象。将患者随机分入A组和B组,每组各64例。两组均给予TURP;B组在TURP基础上,术后服用坦索罗辛。比较两组患者治疗前后的国际前列腺症状评分、生活质量指数评分、最大尿流率、残余尿量及治疗1个月后的不良反应发生率;采用单因素分析法和多元Logistic回归模型分析法判断预后影响因素。结果治疗前,两组患者国际前列腺症状评分、生活质量指数评分、最大尿流率及残余尿量比较,差异均无统计学意义(P>0.05)。治疗后,两组患者国际前列腺症状评分、生活质量指数评分、残余尿量均少于治疗前,且B组少于A组,差异有统计学意义(P<0.05);而最大尿流率高于治疗前,且B组高于A组,差异有统计学意义(P<0.05)。A组不良反应发生率为9.4%(6/64),B组为10.9%(7/64),差异无统计学意义(P>0.05)。单因素分析中,年龄、服用坦索罗辛、治疗前国际前列腺症状评分、前列腺质地、病史均可影响患者预后(P<0.05)。多因素分析中,服用坦索罗辛、治疗前国际前列腺症状评分、病史是BPH患者预后独立影响因素(P<0.05)。结论BPH患者在TURP术后服用坦索罗辛辅助治疗能够有效降低国际前列腺症状评分、生活质量指数评分及残余尿量,并可使最大尿流率增高,且安全性佳,有助于预后恢复。

Objective To observe the clinical effect of transurethral resection of prostate(TURP)combined with tamsulosin in the treatment of benign prostatic hyperplasia(BPH),and to analyze its influencing factors.Methods A retrospective study was performed on 128 cases of patients with BPH who were admitted from March 2015 to December 2018.Patients were randomly divided into Group A and Group B,with 64 cases in each group.TURP was given to both groups.Group B of patients received tamsulosin on the basis of TURP after operation.The international prostate symptom score,quality of life index score,maximum urine flow rate,residual urine volume and the incidence of adverse reactions after one month of treatment were compared between the two groups.Univariate analysis and multivariate Logistic regression model analysis were used to determine the prognostic factors.Results Before treatment,there were no statistically significant differences between the two groups in international prostate symptom score,quality of life index score,maximum urine flow rate and residual urine volume(P>0.05).After treatment,the international prostate symptom score,quality of life index score and residual urine volume of both groups were lower than those before treatment,and Group B was lower than Group A(P<0.05).The maximum urine flow rate was higher in Group B than in Group A before treatment(P<0.05).The incidence of adverse reactions was 9.4%(6/64)in Group A and 10.9%(7/64)in Group B(P>0.05).In univariate analysis,age,tamsulosin,pre-treatment international prostate symptom score,prostate texture,and history of disease all affected the prognosis of patients(P<0.05).In the multivariate analysis,tamsulosin administration,international prostatic symptom score before treatment,and medical history were independent factors influencing the prognosis of BPH patients(P<0.05).Conclusion In BPH patients,adjuvant therapy with tamsulosin after TURP can effectively reduce the international prostate symptom score,quality of life index score and residual urine volume,and can increase the maximum urine flow rate,with good safety,and contribute to the recovery of prognosis.