曲安奈德多点注射联合低功率钬激光治疗前列腺电切术后膀胱颈挛缩的效果观察

Efficacy of multipoint injection of triamcinolone acetonide combined with low-power holmium laser in the treatment of bladder neck contracture after transurethral resection of the prostate

目的分析曲安奈德多点注射联合低功率钬激光治疗经尿道前列腺电切术后膀胱颈挛缩的效果。方法选择西安大兴医院148例经尿道前列腺电切术后膀胱颈挛缩患者作为研究对象,随机分为治疗组和对照组,各74例。治疗组予以曲安奈德多点注射联合低功率钬激光治疗,对照组单纯予以低功率钬激光治疗。比较两组手术时间、术中出血量、住院时间、最大尿流率(Qmax)、残余尿量(PVR)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、复发率情况。结果两组均完成手术并随访,两组患者手术时间、术中出血量、住院时间相当,差异均无统计学意义(P>0.05);术前,两组Qmax和PVR差异均无统计学意义(P>0.05);术后3、6个月,治疗组Qmax大于对照组,PVR小于对照组(P<0.05);术前,两组IPSS和QOL差异均无统计学意义(P>0.05);术后3、6个月,治疗组IPSS、QOL均低于对照组(P<0.05);两组术后3个月复发率比较无差异(P>0.05);术后6个月,治疗组复发率低于对照组(P<0.05)。结论曲安奈德多点注射联合低功率钬激光治疗经尿道前列腺电切术后膀胱颈挛缩的效果明确,且优于传统单纯低功率钬激光治疗,在促进术后康复、减少复发率上具有优势,值得临床推广应用。

Objective To analyze the effect of multipoint injection of triamcinolone acetonide combined with low-power holmium laser in the treatment of bladder neck contracture after transurethral resection of the prostate.Methods A total of 148 patients with bladder neck contracture after transurethral resection of the prostate in Xi'an Daxing Hospital were selected as the study objects and randomly divided into treatment group and control group,with 74 cases in each group.The treatment group was treated with multipoint injection of triamcinolone acetonide combined with low-power holmium laser,while the control group was treated with low-power holmium laser.The operation time,intraoperative blood loss,hospital stay,maximum flow rate(Qmax)and postvoid residual urine volume(PVR),International Prostate Symptom Score(IPSS),quality of life score(QOL),and recurrence rate were compared between the two groups.Results Both groups completed the operation and were followed up,and the operation time,intraoperative blood loss and hospital stay were similar between the two groups,with no statistical significance(P>0.05).Before operation,there was no significant difference in Qmax and PVR between the two groups(P>0.05).At 3 and 6 months after operation,Qmax of the treatment group was higher than that of the control group,and PVR was lower than that of the control group(P<0.05).Before operation,there was no significant difference in IPSS and QOL between the two groups(P>0.05).At 3 and 6 months after operation,IPSS and QOL of the treatment group were lower than those of the control group(P<0.05).There was no significant difference in the recurrence rate between the two groups at 3 months after operation(P>0.05).Six months after operation,the recurrence rate of the treatment group was lower than that of the control group(P<0.05).Conclusion Multipoint injection of triamcinolone acetonide combined with low-power holmium laser in the treatment of bladder neck contracture after transurethral resection of the prostate has a clear effect,and is superior to traditional low-power holmium laser alone.It has advantages in promoting postoperative rehabilitation and reducing recurrence rate,and is worthy of clinical application.