膀胱造瘘与留置尿管保守治疗前列腺增生尿潴留的对比研究

Comparative Study of Cystostomy with Indwelling in the Conservative Treatment of Benign Prostatic Hyperplasia Urinary Retention

目的比较膀胱造瘘管与长期留置尿管在治疗前列腺增生患者尿潴留中的优劣。方法收集2010年1月至2014年6月成都医学院第一附属医院泌尿外科收治的仅适于保守治疗前列腺增生尿潴留患者共165例,最终纳入147例进行分析。按照治疗措施,将患者随机分为膀胱造瘘组(n=73)与留置尿管组(n=74),观察两组患者发生膀胱痉挛、尿路感染、肉眼血尿、瘢痕出血、尿道狭窄、漏尿等并发症的发生情况。结果膀胱造瘘组与留置尿管组并发症的总发生率差异无统计学意义(P>0.05),膀胱造瘘组漏尿的发生率高于留置尿管组,差异有统计学意义(P<0.05)。结论与膀胱造瘘相比,患者更易于接受留置尿管,对生活影响也更小,具有一定的优势,故前列腺增生并发尿潴留患者在无法耐受手术且仅适于保守治疗的情况下,首先建议长期留置尿管。

Objective To investigate and compare the indwelling catheter and bladder fistula in solving the urinary retention of patients with benign prostatic hyperplasiaand to analyze the advantages and disadvantages.Methods 147 cases of urinary retention due to benign prostatic hyperplasia suitable for conservative therapy from January 2010 to June 2014 in our hospital were studied.The patients were randomly divided into 2groups,bladder stoma in 73 cases,indwelling catheter in 74 cases.Results The complication rates in two groups were not significantly different（P〉0.05）.Leakage of urine in cystostomy group was higher than that in indwelling catheter group,and the incidence of complications was significantly different（P〉 0.05）.Conclusion Comparison of indwelling catheter and the bladder fistula,patients are more likely to accept indwelling catheter,as it causes less influence on life,having certain advantages.In the condition of not tolerant for transurethral resection of the prostate operation,the long-term indwelling catheter is the first choice.