3D打印模型辅助下经尿道前列腺手术治疗良性前列腺增生症的临床观察

The clinical observation of transurethral prostatectomy assisted by 3D printing model in the treatment of benign prostatic hyperplasia

目的研究3D打印模型辅助经尿道前列腺电切术(TURP)治疗良性前列腺增生症(BPH)的临床价值。方法前瞻性纳入2018年4月至2020年4月滨州医学院烟台附属医院收治的84例BPH患者作为研究对象,采用随机数字表法将其分为观察组和对照组,每组42例。观察组行3D打印模型辅助TURP治疗,对照组行常规TURP。记录2组患者手术和住院基本情况;比较2组患者术前、术后1周、术后1个月的国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、膀胱残余尿量(PVR);记录2组患者术后并发症发生情况。结果观察组患者手术时间、导管留置时间及术后住院时间显著短于对照组,术中出血量显著低于对照组,差异均有统计学意义(P <0.05)。2组患者术前、术后1个月时IPSS评分、PVR及Qmax水平比较,差异均无统计学意义(P> 0.05);术后1周时观察组IPSS评分和PVR水平显著低于对照组,Qmax值显著高于对照组,差异均有统计学意义(P <0.05)。观察组术后泌尿系感染、低钠血症、术后出血及尿潴留发生情况较对照组显著减轻,差异均有统计学意义(P <0.05);2组术后膀胱痉挛、尿失禁并发症发生情况比较,差异无统计学意义(P> 0.05)。结论 3D打印模型用于TURP治疗BPH疗效可靠,有助于降低术后并发症发生率,缩短住院时间,促进患者术后早期康复。

Objective To study the clinical value of transurethral resection of the prostate(TURP)assisted by 3D printing model to treat the benign prostatic hyperplasia(BPH).Methods There were 84 cases patients with BPH in Yantai Affiliated Hospital of Binzhou Medical College from April 2018 to April 2020,who were included as the research objects,and the prospective comparative research were carried out.They were randomly divided into observation group and control group,42 cases in each group.The observation group was treated with 3D printing model assisted with TURP,the control group received routine TURP.The operation and hospitalization of the two groups were recorded,international prostatic symptom score(IPSS),the maximum flow rate(Qmax)and post-void residual(PVR)between the two groups before surgery,one week after surgery,and one month after surgery were compared.The postoperative complications of the two groups were recorded.Results The operation time,catheter retention time and hospitalization time after operation of the observation group were significantly shorter than those of the control group,the difference were statistically significant(P<0.05).There were no significant difference in IPSS score,PVR and Qmax between the two groups before surgery,one month after operation(P>0.05).The IPSS score and PVR level of observation group were significantly lower than those of control group one week after operation,and the Qmax value was significantly higher than that of control group,the difference were statistically significant(P<0.05).The urinary tract infection,hyponatremia,postoperative bleeding and urinary retention in the observation group were significantly reduced,which compared with the control group,the difference were statistically significant(P<0.05).There was no significant difference in postoperative bladder spasm and urinary incontinence between the two groups(P>0.05).Conclusion The 3D printing model for TURP in the treatment of BPH is reliable,which can reduce the incidence of postoperative complications,shorten the length of hospital stay,and promote the early recovery of patients.