球囊导管结合等离子治疗男性后尿道狭窄疗效观察

Efficacy of balloon catheter combined with plasma in the treatment of male posterior urethral stricture

目的探讨球囊导管结合等离子治疗男性后尿道狭窄的临床经验。方法选择2017年8月至2019年11月承德医学院附属医院收治男性尿道狭窄患者42例。采用随机数字表法分为内镜组和开放组各21例,内镜组进行球囊导管结合等离子电切术治疗,开放组进行尿道狭窄段切除端端吻合成形术治疗,统计两组患者手术时间、术中失血量、术后住院天数、住院费用;检测术前和术后拔除尿管1个月最大尿流率(Qmax)、残余尿量(residual urine volume,RUV)、国际前列腺症状(international prostate symptom score,IPSS)评分、生活质量(quality of life assessment,QOL)评分;记录拔管后6个月国际勃起功能(international index of erectile function,IIEF-5)评分;对比两组术后1年并发症发生率。结果内镜组的手术时间、术中失血量、术后住院天数低于开放组,差异有显著性(P<0.05);内镜组的住院费用高于开放组,差异有显著性(P<0.05);术后1年,内镜组手术并发症发生率与开放组差异无显著性(P>0.05)。两组术后RUV均低于术前,术后Qmax均高于术前(P<0.05);两组手术前后内镜组RUV、Qmax与开放组差异无显著性(P>0.05);两组术后IPSS评分、QOL评分、IIEF-5评分均较术前降低,差异有显著性(P<0.05);两组术前的IPSS评分、QOL评分、IIEF-5评分差异无显著性(P>0.05);两组术后的IPSS评分、QOL评分差异无显著性(P>0.05),内镜组术后的IIEF-5评分高于开放组,差异有显著性(P<0.05)。结论球囊扩张后继续等离子切除术治疗后尿道狭窄能改善患者排尿功能,提高生活质量。

Objective To investigate the clinical experience of balloon catheter combined with plasma in the treatment of posterior urethral stricture.Method From August 2017 to November 2019,42 cases of male patients in Affiliated hospital of Chengde medical university with urethral stricture were selected.By random number table method,21 patients were divided into endoscopic group and open group,the endoscopic group used catheter balloon joint plasma treatment,the other using urethroplasty of treatment,the two groups statistically analyze the operation time,intraoperative blood loss,postoperative hospital stay,hospital cost.The maximum urine flow rate(Qmax),residual urine volume(RUV),international prostate symptom score(IPSS),quality of life(QOL)score were measured before and after 1 month of catheter removal.International erectile function(IIEF-5)score was recorded 6 months after extubation.The incidence of postoperative complications was compared in the two groups at 1 year.Results The operative time,intraoperative blood loss,and postoperative hospital stay in the endoscopic group were lower than another(P<0.05).The hospitalization cost of endoscopic group was higher than open group(P<0.05).One year after surgery,the incidence of complications was not significantly different in the two groups(P>0.05).The postoperation RUV of the two groups lower than preopration,and postoperation Qmax higher than preopration(P<0.05).There were no significant differences in RUV and Qmax between the two groups before and after surgery(P>0.05).Compared with preoperation,the IPSS,QOL and IIEF-5 score of the two groups were lower after operation(P<0.05).There were no significant differences in preoperative IPSS,QOL and IIEF-5 score between the two groups(P>0.05).There was no significant difference in postoperative IPSS and QOL score between the two groups(P>0.05),but the postoperative IIEF-5 score of the endoscopic group was higher than another(P<0.05).Conclusion Balloon catheter combined with plasma for posterior urethral stricture can improve urination function and quality of life.