经尿道前列腺剜除术治疗前列腺增生伴膀胱逼尿肌收缩无力患者的临床研究

Clinical research of transurethral evaporation of prostate in the treatment of benign prostatic hyperplasia accompanies weak contractility of the bladder detrusor

目的分析经尿道前列腺剜除术(TUEP)治疗前列腺增生(BPH)伴膀胱逼尿肌收缩无力患者的临床效果。方法选取2014年1月~2015年12月在我院收治的110例BPH伴膀胱逼尿肌收缩无力患者,随机分为观察组和对照组,每组55例。观察组采用TUEP治疗,对照组采用经尿道前列腺电切术(TURP)治疗。统计两组患者的手术时间、术中出血量、前列腺切除质量、膀胱冲洗时间、导管留置时间,比较两组患者手术前后的国际前列腺症状评分(IPSS)、最大尿流率(Q_(max))、残余尿量(PVR),比较两组术中及术后3个月内的并发症发生情况。结果观察组的手术时间、膀胱冲洗时间及导管留置时间显著短于对照组,差异有统计学意义(P<0.05)。观察组的术中出血量少于对照组,前列腺切除质量显著高于对照组,差异有统计学意义(P<0.05)。两组术后的IPSS、PVR显著低于术前,Q_(max)高于术前,差异有统计学意义(P<0.05)。两组术后的IPSS、Q_(max)、PVR比较,差异无统计学意义(P>0.05)。观察组术后的总并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论 TUEP治疗BPH伴膀胱逼尿肌收缩无力患者较TURP手术时间、膀胱冲洗时间及导管留置时间短,术中出血量更少,前列腺病变组织切除更彻底,且前者可有效改善BPH症状及膀胱逼尿肌收缩功能,并发症少,具有手术风险低、安全性更高的明显优势。

Objective To analyze the clinical effect of transurethral evaporation of prostate （TUEP） in the treatment of benign prostatic hyperplasia （BPH） accompanies weak contractility of the bladder detrusor.Methods 110 patients with BPH accompanies weak contractility of the bladder detrusor in our hospital from January 2014 to December 2015 were selected and randomly divided into the observation group and the control group,with 55 cases in each group.The obser- vation group was treated with TUEP,and the control group was treated with transurethral resection of prostate （TURP）. The time of the operation,bladder douche,catheter indwelling and intraoperative blood loss,weight of resected tissue of prostate of the two groups were recorded.The changes of the international packet switched service score （IPSS）,maximum urine flow rates （Q,~,） and post-void residual volumes （PVR） before and after surgery of the two groups were com- pared.The incidence of complications were recorded of the two groups intraoperative and during 3 months after postop- erative.Results The operation time,bladder douche time and catheter indwelling time in the observation group were sig- nificantly shorter than those in the control group,with significant difference （P〈0.05）.The intraoperative blood loss in the observation group was significantly shorter than that in the control group,the weight of reseeted tissue of prostate in the observation group was significantly higher than that in the control group,with significant difference （P〈0.05）.The postoperative IPSS and PVR in the two groups were significantly lower than those before the operation,and the Qmax in the two groups was higher than that before the operation,with significant difference （P〈0.05）.There was no significant differences in the IPSS,Qmax, and PV R after operation between the two groups （P〉0.05）.The incidence rate of the total complications after the operation in the observation group was significantly lower than that in the control group,with significant difference （P〈0.05）.Conclusion The time of the operation,bladder douche,catheter indwelling of TUEP are shorter than that of TURP,and the blood loss in the operation is less,in addition,the prostatic hyperplasia is resected more thoroughly,which can effectively improve the function of bladder detrusor of patients.TUEP has obvious advantages of fewer complications,lower surgical risk and higher security.