Nesbit法联合前列腺尖部剜除治疗高危良性前列腺增生症的临床探讨

Clinical study on Nesbit method combined with prostate apex enucleation in the treatment of high risk benign prostatic hyperplasia

目的 探讨Nesbit法联合前列腺尖部剜除治疗高危良性前列腺增生症患者的安全性、疗效及其应用价值.方法 回顾性分析采用Nesbit法联合前列腺尖部剜除治疗40例高危良性前列腺增生症患者临床资料.结果全组40例均手术顺利,手术时间60～80 min,平均手术时间（71.0±3.5）min.术后随访6个月,2例失访,前列腺症状评分（IPSS）由术前（24.6±4.3）分降至术后（7.6±1.3）分,生活质量评分（QOL）由术前（4.9±1.2）分降至术后（2.1±0.6）分,最大尿流率（Qmax）由术前（5.6±1.8）ml/s升至术后（21.6±2.2）ml/s,剩余残余尿（RUV）由术前（182±18.5）mL 降至术后（18.3±3.1）mL,4项指标与术前比较差异均具有统计学意义（P＜0.01）.结论 Nesbit法联合前列腺尖部剜除具有疗效确切、安全性高、手术时间短、并发症少的优点,尤其适用于高危良性前列腺增生症患者,且相对简单易学,便于临床推广应用.

Objective To explore the safety, efficacy, and application value of Nesbit method combined with prostate apex enucleation in the treatment of high risk benign prostatic hyperplasia（HRBPH）.Methods The clinical data of 40 HRBPH patients treated with Nesbit method combined with prostate apex enucleation were analyzed retrospectively. Results All patients underwent the operation smoothly, and the operation times ranged from 60 min to 80 min, averaging（71±3.5） min. Thirty-eight patients were followed up for a period of 6 months. International Prostate Symptom Score （IPSS） decreased from preoperative （24.6±4.3） to postoperative （7.6±1.3）, Quality of Life Score （QOL） decreased from preoperative （4.9±1.2） to postoperative （2.1±0.6）, and residual urine volume （RUV） decreased from preoperative （18.2±18.5）ml to postoperative （18.3±3.1）ml, while the maximal urinary flow rate increased （Qmax） from preoperative （5.6±1.8）ml/s to postoperative （21.6±2.2）ml/s, all with statistical significance（P＜0.01）. Conclusion Nesbit method combined with prostate apex enucleation has benefits of determined efficacy, safety, shorter operation time, and less complication. It is especially suitable for the HRBPH patients, and relatively easy to learn for clinical application.