坦索罗辛改善经尿道前列腺1470 nm激光汽化切除术后LUTS的临床研究

Clinical study of tamsulosin on LUTS after transurethral resection of prostate with 1470 nm laser

目的 探讨坦索罗辛改善患者经尿道前列腺1470 nm激光汽化切除术后下尿路症状(lower urinary tract symptoms,LUTS)的临床作用。方法 回顾性分析342例经尿道前列腺1470 nm激光汽化切除术的前列腺增生患者资料,按照术后是否应用坦索罗辛分为两组,治疗组(服用坦索罗辛)178例,对照组(未服用坦索罗辛)164例,对两组患者拔除尿管后4 h、24 h、1周、2周、4周进行IPSS评分并进行统计分析。对拔管后1周、2周、4周的IPSS评分按排尿期症状、储尿期症状IPSS评分进行亚层分析。结果 两组基线特征无差异(P>0.05)。治疗组拔管后各时间点IPSS均明显低于对照组(P<0.05)。两组IPSS在拔管后4 h较术前均有升高(P<0.001),但是对照组升高更明显(P<0.001)。拔管后24 h IPSS治疗组已经明显低于术前(P<0.001),而对照组刚下降至术前水平(P>0.05)。治疗组储尿期症状IPSS在拔管后1周、2周、4周时均明显低于对照组(P<0.05)。排尿期症状IPSS在拔管后1周、2周时治疗组低于对照组(P<0.05),在拔管后24 h差异消失(P<0.05)。各组内不同时间点的排尿期症状IPSS无差异(P>0.05),而储尿期症状IPSS在各时间点均有显著统计学差异(P<0.001)。结论 经尿道前列腺1470 nm激光汽化切除术后服用坦索罗辛有助于缓解患者拔管后出现的LUTS。

Objective To investigate the clinical effect of tamsulosin on LUTS after transurethral resection of prostate with 1470 nm laser. Methods The data of 342 patients with benign prostatic hyperplasia who underwent transurethral 1470 nm laser vaporization resection of the prostate were analyzed retrospectively.They were divided into two groups according to whether tamsulosin was used after operation. 178 cases in the treatment group(taking tamsulosin)and 164 cases in the control group(not taking tamsulosin). IPSS scores were performed 4 hours, 24 hours, 1 week, 2weeks and 4 weeks after catheter removal in the two groups. The IPSS scores of 1 week, 2 weeks and 4 weeks after extubation were analyzed further according to the IPSS scores of micturition symptoms and urine storage symptoms. Results There was no difference in baseline characteristics between 2 groups(P>0.05). IPSS in the treatment group was significantly lower than that in the control group at each time point after extubation(P<0.05). IPSS in both groups increased 4hours after extubation compared with that before operation(P<0.001), but the increase was more obvious in the control group(P<0.001).24 hours after extubation, the IPSS in treatment group was significantly lower than that before operation(P<0.001), while the control group just decreased to the preoperative level(P>0.05). IPSS in the treatment group was significantly lower than that in the control group at 1, 2 and 4 weeks after extubation(P<0.05). The urination symptoms IPSS in the treatment group were lower than those in the control group at 1 and 2 weeks after extubation(P<0.05),and the difference disappeared at 24 hours after extubation(P<0.05). There was no difference in IPSS at different time points in each group(P>0.05), but there was significant statistical difference in IPSS at different time points(P<0.001).Conclusion Taking tamsulosin after 1470 nm laser vaporization resection of the prostate is helpful to alleviate the LUTS symptoms after extubation.