经尿道前列腺电切术后储尿期症状状况分析

Analysis of urinary storage symptoms following transurethral resection of the prostate

目的:通过对经尿道前列腺电切术(TURP)术后下尿路症状(LUTS),尤其是储尿期症状的改变状况分析,提高TRUP术后管理水平和患者生活质量。方法:对我院86例(年龄56～85岁)因患良性前列腺增生(BPH)行TURP者拔除尿管后第1、3、7、15天及第30天进行排尿症状的直接或电话随访,并按术前有和无膀胱逼尿肌不稳定和/或膀胱顺应性差,分为A组和B组。了解两组患者拔管后IPSS评分及储尿期症状评分的变化。结果:86例患者中有15例失访,在有效的71例患者中,其中有膀胱逼尿肌不稳定和/或膀胱顺应性差者28例(A组),不伴有膀胱逼尿肌不稳定和/或膀胱顺应性差者43例(B组)。71例患者拔除尿管后IPSS评分,第1、3、7、15天分别为(8.1±2.5)分、(7.2±3.1)分、(5.3±4.2)分、(6.3±3.8)分、(5.3±4.2)分、(2.4±3.4)分,第1天与第3天比较,以及第15天与第7天比较无统计学差异(P>0.05);而第7天与第1天比较,以及第30天与第15天比较,均有统计学差异(P<0.05)。拔除尿管后第1天LUTS表现以尿频、尿急及急迫性尿失禁等储尿期症状为主,A组IPSS评分(10.4±3.3)分,储尿期症状评分(9.3±3.8)分;B组IPSS评分(6.2±2.8)分,储尿期症状评分(5.2±2.7)分,两组IPSS评分比较及储尿期症状评分比较,均有统计学差异(P<0.05),经舍尼亭及α肾上腺素受体阻滞剂治疗后,拔管后第15天与拔管后第30天两组IPSS评分及储尿期症状评分比较均无统计学差异(P>0.05)。结论:TURP术后排尿症状特别是储尿期症状与术前膀胱功能密切相关且随术后时间推移而逐渐好转。

Objective：To explore the lower urinary tract symptoms（LUTS）,especially those in the urinary storage phase,following transurethral resection of the prostate（TURP）,and to improve the postoperative management and patients＇ quality of life after TURP.Methods：A total of 86 patients with benign prostate hyperplasia（BPH）underwent TURP,and were interviewed on urinary symptoms at 1,3,7,15 and 30 days after removal of the catheter.The patients were divided into two groups according to whether they had preoperative detrusor instability and/or compliance of the bladder（Group A）or not（Group B）,and observed for the changes in IPSS scores and urinary storage symptoms after removal of the catheter.Results：Complete follow-ups were achieved in 71 cases,28 with detrusor instability and/or compliance of the bladder and the other 43 without.Their IPSS scores on the 1st,3rd,7th,15th and 30th day after removal of the catheter were 8.1±2.5,7.2±3.1,6.3±3.8,5.3±4.2 and 2.4±3.4,respectively,with statistically significant differences between the 7th and the 1st as well as the 30th and the 15th day（P 0.05）,but not between the 1st and the 3rd nor the 15th and the 7th day（P 0.05）.On the 1st day,the cardinal symptoms in the urinary storage phase were urinary frequency,urgency and incontinence;the scores on IPSS and urinary storage symptoms were 10.4±3.3 and 9.3±3.8 in Group A and 6.2±2.8 and 5.2±2.7 in Group B,with significant differences between the two groups（P 0.05）.After treatment with tolterodine and α-adrenoreceptor inhibitor,neither IPSS scores nor the scores on urinary storage symptoms showed any significant differences between Groups A and B on the 15th and 30th day（P 0.05）.Conclusion：The lower urinary tract symptoms following TURP,especially those in the urinary storage phase,are correlated with preoperative bladder function,and getting improved gradually after surgery.