保留改良尿管联合经尿道前列腺切除术治疗晚期前列腺癌出血合并膀胱填塞的临床疗效

Clinical efficacy of preserving modified urinary catheter combined with transurethral prostatectomy in the treatment of advanced prostate cancer hemorrhage with bladder tamponade

目的探讨保留改良尿管联合经尿道前列腺切除术治疗晚期前列腺癌出血合并膀胱填塞的疗效。方法选取2016年1月至2020年10月本院收治的106例晚期前列腺癌出血合并膀胱填塞患者作为研究对象,采用随机数字表法分为对照组(n=50)与观察组(n=56)。对照组采用常规导尿联合经尿道前列腺切除术,观察组在对照组基础上于术后应用保留改良尿管,比较两组术前、术后2个月国际前列腺症状评分(IPSS)、生命质量评分(QOL)及术后3 d内膀胱痉挛率、术后导尿管堵塞率、更换尿管率、术后膀胱持续冲洗引流液颜色变淡时间、拔管时间。结果术后2个月,两组IPSS、QOL评分均低于术前,且观察组IPSS评分低于对照组,差异有统计学意义(P<0.05),但两组QOL评分比较差异无统计学意义。观察组术后3 d内膀胱痉挛率、术后导尿管堵塞率、更换尿管率均低于对照组,差异有统计学意义(P<0.05)。观察组术后膀胱持续冲洗引流液颜色变淡时间、拔管时间短于对照组,差异有统计学意义(P<0.05)。结论经尿道前列腺切除术能姑息性治疗晚期前列腺癌出血合并膀胱填塞,联合术后保留改良导尿管可减轻患者下尿路症状,降低术后并发症发生率,有助于促进患者尽快康复。

Objective To explore the efficacy of preserving modified urinary catheter combined with transurethral prostatectomy in the treatment of advanced prostate cancer hemorrhage with bladder tamponade.Methods 106 patients with advanced prostate cancer hemorrhage with bladder tamponade admitted to our hospital from January 2016 to October 2020 were selected as the research subjects,and they were divided into the control group(n=50)and the observation group(n=56)according to the random number table method.The control group received conventional catheterization combined with transurethral prostatectomy,and the observation group received modified urethral catheter after surgery on the basis of the control group,the international prostatic symptom score(IPSS),quality of life(QOL)score before and 2 months after surgery,and the bladder spasm rate within 3 d after surgery,postoperative catheter blockage rate,catheter replacement rate,postoperative continuous bladder irrigation and drainage fluid color fading time,and extubation time were compared between the two groups.Results 2 months after surgery,the IPSS and QOL scores of the two groups were lower than those before surgery,and the IPSS score in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05),but there was no statistically significant difference in QOL score between the two groups.The rate of bladder spasm within 3 d after surgery,the rate of postoperative catheter blockage and the rate of catheter replacement in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The postoperative continuous bladder irrigation and drainage fluid color fading time,and extubation time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Transurethral prostatectomy can palliative treatment for advanced prostate cancer hemorrhage,combined with postoperative preserving modified urinary catheter can can alleviate the lower urinary tract symptoms of patients,reduce the incidence of postoperative complications,and help to promote the speedy recovery of patients.