前列腺体积对经尿道前列腺电切术治疗效果的影响

The impact of prostate volume on the outcomes of transurethral resection of the prostate

目的评估前列腺体积对经尿道前列腺电切术治疗效果的影响。方法回顾性分析我院2012年1月至2014年7月收治的220例行经尿道前列腺电切术患者资料,所有患者术后病理均为良性前列腺增生。根据前列腺体积将患者分为三组:A组前列腺体积(PV)<40 ml,B组PV 40~80 ml,C组PV>80 ml。统计所有患者术前及术后1个月国际前列腺症状评分(IPSS),生活质量评分(QOL)、最大尿流率(Qmax)、平均尿流率(Qave)、残余尿量(RUV)、前列腺特异抗原(PSA)及术后并发症等数据资料。结果 A组51例,年龄(71±10)岁;B组107例,年龄(71±9)岁;C组62例,年龄(72±7)岁。三组患者除前列腺体积外其他术前基础指标差异无统计学意义(P>0.05),术中及术后并发症发生情况差异无统计学意义(P>0.05),术后排尿情况较术前明显改善,但三组间比较,仅Q-max和Q-ave手术前后变化值差异有统计学意义(P<0.05),IPSS、QOL及RUV组间比较差异无统计学意义(P>0.05)。结论前列腺体积大小不是经尿道前列腺电切术并发症发生决定因素,不限制前列腺电切术适应范围,不影响主观排尿困难症状和生活质量评分,但中度前列腺增生者(PV=40~80 ml)电切术后尿流率改善更明显。

Objective To investigate the effect of prostate volume on the outcomes of transurethral resection of the prostate （TURP）. Methods A retrospective study was conducted to summarize the cases who received TURP for BPH from January 2012 to July 2014. These patients were divided into three groups according to different prostate volume （PV） （Group A： PV〈40 ml; Group B： PV=40-80 ml; Group C： PV〉80 ml）. The international prostate symptom score （IPSS）, qulity of life score（QOL）, maximum urine flow（Qmax）, average flow rate （Qave）, residual urine volume （RUV）, prostate-specific antigen （PSA） and the postoperative complications in all patients were compared between pre- and post-surgery. Results Group A： 51 patients, （71_±10） years old, Group B： 107 patients, （71±9） years old, Group C： 62 patients, （72±7） years old. No statistically significant differences were observed on all indicators of preoperative and complications after TURP （P〉0.05）. All patients urination improved after surgery, but among the three groups, only the Qmax and Qave changes were statistically significant （P〈0.05）, no significant difference between the IPSS, QOL and RUV changes （P〉0.05）. Conclusions Prostate volume does not affect the choice of TURP, also does not affect the improvement of dysuria symptoms and quality of life, but urinary flow rate improvement was significant for moderate benign prostatic hyperplasia （PV=40-80 ml）.