经尿道钬激光剜除术联合普乐安片治疗良性前列腺增生症的疗效观察

Efficacy research of transurethral holmium laser enudeation of the prostate combined with Pule'an Tablet for the treatment of benign prostatic hyperplasia

目的探讨经尿道钬激光剜除术联合普乐安片治疗良性前列腺增生症的疗效及对血液流变学指标的影响。方法选择前列腺增生症患者100例,按数字表随机分为2组;对照组50例采取经尿道钬激光剜除术;治疗组50例在对照组基础上于术后2 d口服普乐安片,每次3片,每天3次,连续治疗3个月。比较两组国际前列腺症状评分(I-PSS)、排尿症状对生活质量(QOL)的影响及前列腺体积、残余尿量、平均尿流率(Q_(ave))、最大尿流率(Q_(max));比较两组术后3个月内尿失禁等并发症发生率;检测两组治疗前后血液流变学指标。结果治疗后,治疗组I-PSS和QOL评分明显低于对照组(P<0.01);治疗组治疗后前列腺体积和残余尿量明显低于对照组,Q_(ave)和Q_(max)分别明显高于对照组(P<0.01);治疗组不良反应发生率为2%,明显低于对照组的16%(P<0.05);治疗后,治疗组患者的全血高切、中切、低切黏度和血浆黏度均显著低于对照组,差异有统计学意义(P<0.01)。结论经尿道钬激光剜除术联合普乐安片治疗前列腺增生症的疗效明显,改善患者血液流变学水平可能与上述治疗作用密切相关。

Objective To investigate efficacy of transurethral holmium laser enudeation of the prostate combined with Pule′an Tablet for the treatment of benign prostatic hyperplasia and its influence on hemorheology indexes.Methods A hundred patients with benign prostatic hyperplasia were chosen and randomized into two groups according to the random number table method.The control group（50 cases）was treated with transurethral holmium laser enudeation,while the treatment group（50 cases）was given additional Pule′an Tab-lets（3 tablets/time and tid）for 3 months.I-PSS,QOL,prostate volume,residual urine volume,average rate of urine flow,and maximum flow rate were compared between both groups pre-post treatment.Incidence of complications such as uracratia within 3 months was com-pared between both groups.Hemorheology indexes were detected in two groups.Results I-PSS and QOL scores in the treatment group were obviously lower than the control group（P 〈0.01）.Prostate volume and residual urine volume were remarkably lower while average rate of urine flow and maximum flow rate were higher in the treatment group than the control group（P 〈0.01）.Incidence of complica-tions in the treatment group was 2%,significantly lower than 16% in the control group（P 〈0.05）.Blood viscosities of high shear rate, middle shear rate,low shear rate and plasma viscosity in the treatment group were obviously lower than the control group with statistical-ly significant differences（P 〈0.01）.Conclusions Tansurethral holmium laser enudeation of the prostate combined with Pule′an Tab-lets in treating benign prostatic hyperplasia has a significant curative effect,and may be relevant to the improvement in hemorheology in-dexes.