前列腺增生症患者经尿道前列腺电切术后前列腺症状和生存质量评分的变化

Changes in prostate symptoms and quality of life in patients with symptomatic benign prostate hyperplasia before and after transurethral resection of the prostate

目的 探讨经尿道前列腺电切（TURP）对良性前列腺增生症（BPH）患者国际前列腺症状评分（IPSS）和生存质量（QOL）评分的影响.方法 对因BPH导致下尿路症状的47例男性患者（平均72岁）行TURP治疗,比较治疗前后IPSS和QOL评分以及最大尿流率、残余尿量及压力-流率检查等指标的变化,分析影响IPSS及QOL评分的因素.结果 术中均无并发症发生,术后2例前尿道狭窄,1例逆向射精,6例急迫性尿失禁加重,对症处理后症状均缓解.手术前、后IPSS及其刺激、梗阻评分分别为（22.7±4.9）与（10.5±5.8）分,（10.5±5.8）与（6.3±3.5）分,（12.1±3.9）与（4.2±3.3）分,QOL评分为（4.6±0.9）和（2.3±1.3）分,最大尿流率为（5.8±2.9）和（12.4±5.2）ml/s,残余尿量为（99±16）和（34±19）ml,差异均有统计学意义（均P＜0.01）.术后随访时间、前列腺体积和急迫尿意时膀胱容量与术后IPSS有相关性（r=0.751,P＜0.05）,术后随访时间和年龄与术后QOL评分有相关性（r=0.470,P＜0.05）.结论 TURP对存在下尿路症状的BPH患者的IPSS、QOL评分均有显著改善,而影响IPSS和QOL评分的相关因素不尽相同.

Objective To investigate changes in symptoms and quality of life （QOL） score before and after transurethral resection of the prostate （ TURP）, and their related factors. Methods Forty-seven elderly male patients of benign prostate hyperplasia （BPH） with lower urinary tract symptoms were enrolled in the study, with an average age of 72 years. They all were undergone with TURP and evaluated with international prostate symptoms score （IPSS）, QOL score, maximal urine flow rate （Qmax）, residual urine volume, pressure-urine flow rate and prostate size before and after the procedure. Changes in these parameters and their related factors were analyzed. Results No complication was observed during TURP in the 47 patients. After TURP, two patients suffered from distal urethra stricture, one from retrograde ejaculation and six from aggravated urgent incontinence, and symptoms relieved with symptomatic treatment in all of them. Significant difference in overall IPSS, irritant score and obstructive score pre- and post-operation was observed P ＜ 0.01, i. e. , 22.7 ±4.9 and 10.5 ± 5.8, 10.5 ± 5.8 and 6.3 ± 3.5, and 12.1± 3.9 and 4.2 ± 3.3, respectively. QOL score was 4.6 ± 0.9 and 2.3 ± 1.3, Qmax （5.8 ± 2.9 ） ml/s and （12.4 ±5.2） ml/s and residual urine volume （99 ± 16） ml and （34 ± 19） ml pre- and post-operation,respectively （ all P ＜ 0.01 ）. Follow-up time after the procedure, prostate volume and bladder volume at urgent urination desire all correlated with post-operation IPSS （ r = 0.751, P ＜ 0.05 ）, and follow-up time after the procedure and age also significant correlated with post-operation QOL score （r = 0.470, P ＜ 0.05 ）.Conclusions Overall IPSS, irritant score, obstructive score and QOL score improved significantly after TURP in symptomatic BPH patients, probably by varied related factors.