热膨胀螺旋形前列腺支架治疗高危前列腺增生的临床效果分析

Clinical study on the treatment of high-risk BPH with hermo-expandable metallic prostate stent

目的探讨热膨胀螺旋形前列腺内支架治疗高龄前列腺增生的临床疗效和手术经验。方法回顾性分析东部战区总医院2017年1月至2018年10月38例进行热膨胀螺旋形前列腺内支架植入术的前列腺增生患者。患者年龄72~89岁,国际前列腺症状评分(IPSS)术前(25.6±4.1)分,最大尿流率(MRF)(4.8±1.2)mL/s,残余尿量(RUV)(160.7±70.5)mL。7例患者因急性尿潴留放置导尿管4~8 d。结果除1例失败外,37例患者前列腺内支架均一次植入成功,术后立即自行排尿,无严重手术相关并发症。37例患者术后随访3个月IPSS为(15.6±4.3)分、RUV为(40.7±12.9)mL,较术前均显著下降(P<0.05);MRF为(11.1±4.3)mL/s,较术前显著上升(P<0.05)。本组22例随访至2年,IPSS、MRF、RUV均稳定。结论热膨胀螺旋形前列腺支架治疗前列腺增生引起的排尿困难,疗效迅速、可靠、创伤小,尤其对治疗高龄、高危且不适宜手术的前列腺增生患者可作为首选方法。

Objective To investigate the clinical efficacy and surgical experience of hermo-expandable metallic prostate stent in the treatment of elderly high-risk BPH patients.Methods Retrospective analysis was performed on 38 patients with BPH who underwent implantation of hermo-expandable metallic prostate stent from January 2017 to October 2018 in the General Hospital of Eastern Theater Command.The patients were 72 to 89 years old,with preoperative international prostatic symptom score(IPSS)of 25.6±4.1 points,maximum flow rate of urine(MRF)of(4.8±1.2)mL/s,and residual urine volume(RUV)(160.7±70.5)mL.Urinary catheters were placed in 7 patients for 4-8 days due to acute urinary retention.Results Except for the failure in one case,all 37 patients were successfully implanted with the prostate stent at one time,and they urinated immediately after the operation without serious operation-related complications.Follow-up was conducted for 3 months,and the IPSS and RUV of the 37 patients were(15.6±4.3)and(40.7±12.9)mL respectively,which were significantly lower than those before the operation(P<0.05).MRF was(11.1±4.3)mL/s,significantly higher than that before surgery(P<0.05).22 cases in this group were followed up for 2 years,and their IPSS,MRF and RUV were all stable.Conclusion The thermo-expandable metallic prostate stent for the treatment of dysuria caused by BPH is effective,reliable and less traumatic.It is a preferred choice for the treatment of the aged BPH patients who are at a high risk and not suitable for surgery.