输精管结扎对前列腺增生症预防作用的实验与调查研究

Study on Preventing effect of Vasoligation on Benign Prostatic Hyperplasia.

目的:探讨输精管结扎对前列腺增生症(BPH)的预防作用。方法:分实验与调查两系列进行。实验系列:取雄性杂交犬40只,随机分为A、B、C、D4组,每组10只,其中A、B两组制成前列腺增生模型。2年后将A、C两组的双侧输精管连同输精管静脉结扎,B、D两组犬仅解剖显露输精管,但不结扎,继续原方法饲养2年后将40只犬处死解剖出前列腺称重,测量体积,然后分组取材制片,观察组织学改变。调查系列:采用大样本群体抽样方法调查55岁以上男性1240例,其中结扎组850例,对照组390例。对其前列腺症状评分(IPSS)、生活质量指数(QOL)、直肠指诊(DRE)、前列腺体积(V)及残余尿(R)等指标分年龄段进行了综合分析与比较。结果:实验系列A、C两组与B、D两组前列腺重量及体积比较P<0.01,有显著性差异。A、C两组前列腺组织切片呈退行性变而B、D两组呈增生性改变。调查系列结扎组各年龄段BPH的发病率明显低于对照组,而结扎时间在30年以上者BPH的发病率又明显低于结扎时间在20～25年者。结论:在前列腺增生前行输精管及输精管静脉结扎可减轻犬在老年期的前列腺增生,在增生后结扎可使犬前列腺组织发生不同程度的萎缩;输精管结扎可明显降低人在老年期BPH的发病率及减轻临床症状。

Objective:To study preventing effect of vasoligation on benign prostatic hyperplasia( BPH). Methods: male pooches were divided into four groups (A.B.C.D) randomly in the experimental group. Each group has 10 pooches,and Group A and B were made into the modes of BPH. Two years later,the pooches in Group A and C accepted the operation of vasoligation and deferent vein ligation on both sides. Group B and D only accepted the operation of dissection and relieving its deferential duct. The 40 pooches were feeded after the operation and killed two years later. After taking out their prostates and calculating its volume and weight, the sections of the prostates were made and their changes of histology and pathology were observed by microscope. Comparing and analyzing the data such as IPSS, QOL, DRE, V and R in a survey of 1 ,240 cases with an age more than 55 years, the technique of random sampling was used. The experimental group contained 850 cases of vasoligation,which accepted the operation more than 20 years ago. The left 390 cases (control group) didnt accept the operation. Results; Comparing the weight and volume as well as the changes of histology and pathology, Group A and C ( degeneration changes) had a significant difference (P<0. 01). It was the same with Group B and D ( hyperplasia changes). The incidence of BPH in the treatment group was lower than that of the control group. Among the treatment group,the incidence of BPH for the cases operated more than 30 years was lower than that 20 to 25 years. Conclusion; Vasoligation and deferential vein ligation before benign prostatic hyperplasia can reduce the extent of BPH at its old age, and treatment after benign prostatic hyperplasia can make prostatic tissue appear different degrees of atrophy. Vasoligation can obviously reduce the incidence of BPH at old - age and lessen clinical symptom.