经尿道等离子电切术联合无张力疝修补术治疗良性前列腺增生合并腹股沟疝的疗效

Clinical effect of PKRP combined with tension-free herniorrhaphy in the treatment of benign prostatic hyperplasia with inguinal hernia

目的探讨经尿道等离子电切术(PKRP)联合无张力疝修补术同期治疗良性前列腺增生(BPH)合并腹股沟疝的临床效果。方法收集2016年1月至2018年5月,重庆市两江新区第一人民医院行手术治疗的200例BPH合并腹股沟疝患者为研究对象,回顾性分析其临床资料。对照组患者95例,分期行PKRP、无张力疝修补术;观察组患者105例,同期行PKRP联合无张力疝修补术,2组均于围手术期行常规护理;比较2组手术相关指标,统计术后并发症发生情况及复发情况。结果观察组术后住院时间显著短于对照组,术中出血量及手术费用显著少于对照组,差异有统计学意义(P<0.05);2组手术时间、前列腺切除质量比较,差异无统计学意义(P>0.05)。与术前相比,术后6个月2组IPSS、RUV及最大逼尿肌压水平均显著下降,Qmax、膀胱顺应性水平显著升高,且2组间比较,差异有统计学意义(P<0.05)。观察组并发症总发生率及复发率与对照组比较,差异无统计学意义(P>0.05)。结论PKRP联合无张力疝修补术同期治疗BPH合并腹股沟疝可缩短患者术后住院时间,且有利于其前列腺、膀胱功能的恢复。

Objective To explore the clinical effect of plasma kinetic resection of prostate (PKRP) combined with tension-free herniorrhaphy in the treatment of benign prostatic hyperplasia (BPH) with inguinal hernia. Methods 200 patients with BPH complicated with inguinal hernia underwent surgical treatment in the First People's Hospital of Liangjiang New District from January 2016 to May 2018 were selected as the study objects, the clinical data were retrospectively analyzed. PKRP and tension-free hernioplasty was performed by stages in the control group (n=95), with routine nursing in the two groups during perioperative period. While PKRP combined with tension-free hernia repair was performed in the observation group (n=105). Relevant indexes of operation were compared between the two groups, and the occurrence and recurrence of complications were counted between the two groups. Results The postoperative hospitalization time of the observation group was significantly shorter than that of the control group, the amount of intraoperative bleeding and the cost of operation were significantly less than those of the control group (P<0.05), but the operation time of the two groups had no significant difference in the quality of prostatectomy (P>0.05). Compared with before operation, IPSS, RUV and maximum detrusor pressure decreased significantly in both groups at 6 months after operation, while Qmax and bladder compliance increased significantly, and there were significant differences between the two groups (P<0.05). There was no significant difference between the observation group and the control group in the total incidence and recurrence rate (P>0.05). Conclusion PKRP combined with tension-free herniorrhaphy for simultaneous treatment of BPH with inguinal hernia can shorten the postoperative hospitalization time, and is beneficial to the recovery of prostate and bladder function, which is worth popularizing.