经尿道五步法解剖性前列腺切除术的临床观察研究

A Clinical Research of Five-step Transurethral Anatomical Resection of Prostate

目的评价经尿道五步法解剖性前列腺切除术治疗良性前列腺增生症的临床疗效和安全性。方法回顾性分析2017年6月至2019年8月作者单位收治的前列腺增生患者160例,采用经尿道前列腺电切术80例,采用经尿道五步法解剖性前列腺切除术(transurethral five-step anatomical prostatectomy,TUAP)80例。比较两组手术病例术前、术后6周的国际前列腺症状评分(international prostate symptom score,IPSS)、生活质量评分(QOL)、最大尿流率(Qmax),观察两组病例手术中出血量、手术时间、术后尿失禁的发生率等相关指标。结果两组患者手术均获得成功,两组患者术前IPSS评分、QOL评分、Qmax与术后6周指标相比有统计学意义(P<0.01),两组患者手术中出血量、手术时间、术后留置尿管时间差异有统计学意义(P<0.05),TURPA组术后未出现真性尿失禁患者。结论经尿道五步法解剖性前列腺切除术与经尿道前列腺电切术疗效相当,但在手术中出血量、手术时间、术后留置尿管时间、术后尿失禁的发生率方面有明显的优势。经尿道五步法解剖性前列腺切除术是安全有效的手术方式,值得推广。

Objective To evaluate the clinical efficacy and safety of transurethral five-step anatomical prostatectomy for benign prostatic hyperplasia.Methods A retrospective analysis of 160 patients of benign prostatic hyperplasia admitted to our department from June 2017 to August 2019,80 patients underwent transurethral resection of the prostate,and 80 patients underwent transurethral five-step anatomical prostatectomy(TUAP).The international prostate symptom score(IPSS),quality of life score(QOL),and maximum urinary flow rate(Qmax)were compared between the two groups before and 6 weeks post operatively.The amount of bleeding,operation time,and postoperative time were observed in the two groups.Related indicators such as the incidence of urinary incontinence.Results The operations of these two groups were all successful.The preoperative IPSS score,QOL score and Qmax of the two groups were statistically significant compared with the 6-week postoperative index(P<0.01).The amount of bleeding during operation,operation time.There was a statistically significant difference in the time of postoperative indwelling catheter(P<0.05).There was no real urinary incontinence found in the TUAP group.Conclusions Transurethral five-step anatomical prostatectomy is equivalent to transurethral resection of the prostate,but there are obvious advantages in the amount of bleeding during operation,operation time,postoperative indwelling catheter time,and incidence of postoperative urinary incontinence.Transurethral five-step anatomical prostatectomy is a safe and effective surgical procedure.