良性前列腺增生诊断与治疗的20年临床回顾

Retrospective clinical analysis of diagnosis and treatment of patients with benign prostate hyperplasia during 20 years

目的:了解20年来BPH住院患者临床特点和治疗情况的变化,为今后的诊疗提供参考。方法:总结1729例的临床资料。将所有患者按年限分为1986～1995年间及1996～2006年间2组,分析患者年龄、术前并发症、其他慢性病伴随症、前列腺总体积、手术方式、术后并发症在前后2个10年阶段的变化。结果:前10年间诊治患者平均年龄、前列腺体积、术前伴随症发生率、经尿道微创手术比例、术前并发症中泌尿系感染及肾积水发生率要低于后10年,差异有统计学意义(P<0.05);而其他包括急慢性尿潴留发生率2个阶段数据之间差异无统计学意义(P>0.05)。前10年间开放手术比例、术后并发症中伤口感染、肺炎、泌尿系感染及二次手术发生率要大于后10年,差异有统计学意义(P<0.05)。其他并发症差异无统计学意义(P>0.05)。结论:BPH患者就诊年龄趋于老年化,伴随症增多,腺体体积增大,微创手术逐渐替代传统开放手术占据主要地位,术后并发症发生率有所下降。因此当前BPH的治疗应注意患者身体状况,尽量选择对患者打击小的微创手术。

Objective： To retrospectively analyse the clinical characteristic and change of diagnosis and treatment of patients with benign prostate hyperplasia （BPH） at Beijing Friendship Hospital during 20 years and to provide reference for diagnosis and treatment in the future. Methods： We retrospectively reviewed the clinical records of 1 729 patients with BPH at Beijing Friendship Hospital between 1986 and 2006. The patients were divided into two groups on the basis of 10 years. Patients＇ age, preoperative complications, prostate volume, operation method and postoperative morbidities were compared among two groups. We used t test and x2 test to analyse all the data. Results：In the first 10 years group, age, prostate volume, the incidence rate of preoperative chronic diseases, the ratio of minimally invasive operation （e. g. TURP） and the incidence rate of urological infection and hydronephrosis which belongs to preoperative complications were significantly lower than for the latter 10 years group （P〈0.05）, while the ratio of open operation, the incidence rate of wound infection, pneumonia, urological infection and secondary operation which belongs to postoperative morbidities were significantly higher than For the latter 10 years group （P〈0.05）. The other events include preoperative acute and chronic urine retention rate were comparable in the 2 groups. Conclusions：Our results demonstrate age, prostate volume, the incidence rate of preoperative chronic diseases and minimally invasive operation were significantly higher, while the postoperative morbidities rate was significantly lower among 20 years. Therefore, we should pay more attention to the health status of the patients with BPH and choose the minimally invasive treatment as possible as we can.