前列腺增生合并膀胱肿瘤同期行手术治疗临床研究

Clinical research on the surgery treatment for prostate hyperplasia together with bladder tumor simultaneously

目的探讨前列腺增生合并膀胱肿瘤症患者同期进行电切术的疗效。方法对166例患者在征得患者同意的情况下进行分组治疗，A组：膀胱肿瘤部分切除术和耻骨上前列腺摘除术同期进行，60例；B组：经尿道膀胱肿瘤电切术和经尿道前列腺电切术同期进行，66例；C组：单独进行经尿道膀胱肿瘤电切术，40例。结果（1）A组患者的康复情况同B组患者相近，但B组手术时间、平均住院时间分别为（43．2±16．7）min、（11．3±2．4）d，明显低于A组（P〈0．05）；B组术中出血量为（119．5±72．1）ml，明显较A组短少（P〈0．05），同时B组患者术后留置尿管时间为（8．6±2．4）d，明显少于A组（P〈0．05）；（2）A组患者和B组患者术后排尿困难的情况得到明显改善，A、B两组中只有3．2％的患者在术后出现排尿困难，而C组术后有28．5％的患者出现排尿困难；（3）A组患者术中并发症发生率最高（33．2％），其次是C组（21．3％），B组最低（12．6％）；（4）术后平均随访1年，A组膀胱肿瘤复发率为25．3％，B组为18．2％，C组为23．7％，所有复发的肿瘤均为异位复发，在复诊后经电切术进行膀胱肿瘤切割后无一例患者再次复发。结论前列腺增生合并膀胱肿瘤症患者同期进行电切术可以避免患者承受二次手术痛苦，减少患者住院时间，减少医疗费用，手术相对安全，疗效可靠，复发率较低。

Objective To explore the effect of the electrocision treatment for the same period of the prostatic hyperplasia and bladder cancer patients. Methods Doing the grouping therapy for 166 patients in our hospital who have agreed on the research. Group A：doing the bladder tumor part electricity cutting surgery and removing the pros- tate gland excision above pubis simultaneously,60 cases, Group B：doing the bladder tumor part electricity cutting sur- gery and the prostate gland excision transurethral resection electricity cutting simuhaneously,66 cases, Group C：only doing the bladder tumor part electricity cutting surgery transurethral resection,44 cases. Results （ 1 ） Patients＇ recov- ering situation in group A was close to that of patients in group B, but operation time and average hospitalization time was （43.2 ± 16.7 ） min and （ 11.3± 2.4 ） d, which were obviously lower than those of group A （ P 〈 0.05 ）. The amount of blood loss of group B was （ 119.5± 72.1 ） ml, which was obviously less than that of group A （ P 〈 0.05 ）. While the lien urine tube time of group B was （8.6 ± 2.4）d ,less than group A. （2）Patients of group A and group B＇ s dysuresia had been improved obviously after the operation. There were only 3.2% of the patients in group A and group B appearing dysuresia after the operation, but in the group C there was still 28.5% having dysuresia after the operation, （ 3 ） The incidence rate of intraoperative complications was the highest in group A （ 33.2% ）, next group C （21.3%） ,the lowest group B（ 12.6% ）. （4）Follow-up 1 year ,the recurrent rate of the bladder tumor in group A was 25.3% ,group B 18.2% ,group C 23.7% ,all the tumor recurrences are ectopic reeun＇enees,and after the further con- sultation, none of those patients taking the electricity cutting surgery relapse again. Conclusions Patients who have Prostate hyperplasia and bladder cancer can avoid the pain of second surgery by taking the electricity cutting surgery, shorten their length of time in hospital, and reduce the costs of health care. Compared with traditional methods, the method of operation is safe relatively, and can control the incidence of complication effectively. From the follow-up vis- iting,we can find that this surgery has many advantages such as the reliable curative effect, and the lower recurrent rate, so it can be used widely for reference.