经尿道前列腺电切剜除术治疗良性前列腺增生对术后性功能障碍率及机体应激反应的影响

Effect of transurethral resection of prostate for treatment of benign prostatic hyperplasia on postoperative sexual dysfunction rate and body stress response

目的探讨经尿道前列腺电切剜除术(TUERP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)对术后性功能障碍率及机体应激反应的影响。方法选取2017年2月至2018年6月成都市第七人民医院诊治的128例BPH患者作为研究对象。遵循随机对照原则分为两组,TUERP组(n=64)患者接受TUERP治疗,TURP组(n=64)患者接受TURP治疗,术后随访12个月。比较两组患者的手术相关指标、勃起功能障碍发生率、围术期机体应激反应、术后并发症。结果与TURP组患者比较,TUERP组患者术中出血量、血红蛋白(Hb)下降值、血钠下降值均较低,手术时间、术后冲洗液转清时间均较短,腺体切除质量较高,差异均具有统计学意义(均P<0.05);TUERP组患者术后6个月和12个月勃起功能障碍发生率均比TURP组患者低,差异均具有统计学意义(均P<0.05);TUERP组患者术后12h、48h血清C反应蛋白(CRP)、皮质醇(Cor)水平均比TURP组患者低,差异均具有统计学意义(均P<0.05);TUERP组患者术后并发症总发生率(9.38%)稍低于TURP组患者(15.63%),但差异无统计学意义(P>0.05)。结论针对BPH患者实施TUERP治疗具有出血量低、创伤小、腺体切除量高、并发症少等治疗优势,可降低勃起功能障碍发生风险,减轻围术期机体应激反应,预防术后Hb、血钠下降。

Objective To evaluate the effects of transurethral enucleation and resection of the prostate(TUERP)and transurethral resection of the prostate(TURP)on postoperative sexual dysfunction and body stress response in patients with benign prostatic hyperplasia(BPH).Methods 128 patients with BPH admitted to Chengdu Seventh People's Hospital from February 2017 to June 2018 were enrolled.The TUERP group(64 patients)underwent TUERP and the TURP group(64 patients)underwent TURP.Followed up for 12 months.Surgical related indicators,incidence of erectile dysfunction,perioperative body stress response,postoperative complications were compared between the two groups.Results Compared with the TURP group,the intraoperative blood loss,hemoglobin decline and blood sodium decrease were lower in the TUERP group,the operation time,the postoperative rinse time was shorter,and the gland resection quality was higher(all P<0.05).The incidence of erectile dysfunction in the TUERP group was lower than that in the TURP group at 6 and 12 months after operation(all P<0.05).The levels of serum C-reactive protein(CRP)and cortisol(Cor)in the TUERP group were lower than those in the TURP group at 12 and 24 hours after operation(all P<0.05).The total incidence of postoperative complications in TUERP group(9.38%)was slightly lower than that in TURP group(15.63%),but there was no significant difference(P>0.05).Conclusions TUERP for patients with BPH has the advantages of low blood loss,small trauma,high gland resection and less complications,which can reduce the risk of erectile dysfunction and the perioperative stress response,and prevent the decrease of Hb and blood sodium after operation.