经尿道前列腺切除术联合膀胱颈内切开术治疗纤维增生型前列腺所致膀胱出口梗阻的效果评价

Transurethral Resection of Prostate with Incision of Bladder Neck in Benign Prostatic Hyperplasia

目的评价经尿道前列腺切除术(TURP)联合膀胱颈内切开术(TUIBN)治疗纤维增生型前列腺所致膀胱出口梗阻的疗效。方法选取采用手术切除前列腺增生组织质量小于25 g的患者共98例。耻骨上经膀胱前列腺切除术(SPP)组30例,TURP组33例,TURP+TUIBN组35例。术后3个月,复查前列腺症状评分(IPSS)和最大尿流率(Qmax)。结果 SPP组IPSS由(25.4±3.6)分降至(17.1±2.3)分,Qmax由(7.5±3.5)ml/s升至(11.5±3.0)ml/s;TURP组IPSS由(24.3±3.3)分降至(13.2±1.7)分,Qmax由(7.8±3.6)ml/s升至(13.2±4.5)ml/s;TURP+TUIBN组IPSS由(25.5±3.0)分降至(9.3±1.6)分,Qmax由(9.1±3.8)ml/s升至(16.8±4.2)ml/s。3组患者术前IPSS、Qmax比较,差异均无统计学意义(P>0.05);3组患者术后IPSS、Qmax比较,差异均有统计学意义(P<0.05)。TURP+TUIBN组与SPP组、TURP组患者术后IPSS、Qmax比较,差异均有统计学意义(P<0.01)。结论 TURP+TUIBN治疗纤维增生型前列腺增生所致膀胱出口梗阻疗效满意,且创伤小,痛苦少,恢复快,是较理想的治疗方法。

Objective to evaluate the effect of transurethral resection of prostate （TURP） combined with transurethral incision of bladder neck （TUIBN） in treatment of benign prostatic hyperplasia. Methods Ninety - eight patients with surgical removal of prostatic hyperplasia weighing less than 25 g were chosen, including 30 cases of suprapubic transvesical prostatectomy （ group SPP）, 33 TURP （ group TURP）, 35 TURP ＋ TUIBN （group TURP ＋ TUIBN）. The prostate symptom score （IPSS） and maximal urinary flow rate indicators （Qmax） were reviewed 3 months after operation. Results In SPP group, IPSS decreased from （25.4±3.6） to （17.1±2.3）, Qmaxincreased from （7.5 ±3.5） ml/s to （11.5 ±3.0） ml/s; in TURPgroup, IPSS from （24.3±3.3） to （13.2±1.7）, Qmax from （7.8±3.6） ml/sto （13.2±4.5） ml/s; inTURP＋TUIBN group, IPSS from （25.5 ± 3. 0） to （9. 3 ±1. 6）, Qmax from （9. 1± 3.8 ） ml/s to （ 16. 8 ± 4.2 ） ml/s. There was not significant difference in IPSS, Qmax between 3 groups before operation （ P 〉 0. 05 ）, but there was after operation （ P 〈 0.05 ）. TURP ＋ TUIBN group was significantly different from groups SPP, TURP in IPSS, Qmax after operation （P 〈 0.01 ）. Conclusion TURP ＋ TUIBN, which has satisfactory effects, with smaller traumas, less pain, rapid recovery in treatment of BPH - caused bladder outlet obstruction, is an ideal treatment.