小体积前列腺增生引起膀胱出口梗阻三种术式疗效的比较  

Comparative Evaluation of Open Surgery,Transurethral Resection of Prostate,and Transurethral Resection of Prostate Plus Transurethal Incision of Bladder Neck for Bladder Outlet Obstruction Caused by Small Benign Prostatic Hyperplasia

作　　者：蒋雷鸣[1] 杨燕伟[1] 葛波[1] 张天禹[1] 覃展偶[1] 曾宪华[1] 李勇平[1] 

机构地区：[1]广西桂林医学院附属医院泌尿外科,广西桂林541001

出　　处：《中国医师杂志》2005年第10期1343-1344,共2页Journal of Chinese Physician

摘　　要：目的探讨小体积前列腺增生引起膀胱颈出口梗阻的较理想治疗方法.方法自1996-01～2005-01共收治小体积前列腺增生69例,其中耻骨上经膀胱前列腺摘除27例,单纯经尿道前列腺电切除术(TURP)22例,TURP加膀胱颈内切开术(TUIBN)20例.三组患者年龄、病程、术前前列腺重量及手术切除重量均无明显差异.从国际前列腺症状评分(IPSS)、最大尿流率(Qmax)及膀胱残余尿量(PVR)三个参数来比较三组治疗的疗效. 结果术后各项指标均有改善,分别为开放手术组IPSS由(24.6±3.8)降至(15.1±3.8),Qmax由(8.2±3.1)ml/s升至(10.5±4.2)ml/s,PVR由(96.0±36.0)ml降至(54.0±27.0)ml.单纯TURP组IPSS由(22.3±5.6)降至(11.7±2.7),Qmax由(8.5±3.6)ml/s升至(11.4±4.2)ml/s,PVR由(105.0±39.0)ml降至(32.0±14.0)ml.TURP加TUIBN组IPSS由(23.6±5.7)降至(6.4±2.3),Qmax由(9.1±3.8)ml/s升至(19.5±6.2)ml/s,PVR由(98.0±37.0)ml降至(8.0±5.0)ml.TURP加TUIBN组与另两组比较,术后IPSS、Qmax及PVR均有极显著性差异(P＜0.001).结论 TURP 加TUIBN是目前治疗小体积前列腺增生引起膀胱颈出口梗阻较为理想的方法.Objective To explore an efficient treatment for bladder outlet obstruction caused by small benign prostatic hyperplasia （BPH）. Methods From January 1996 to January 2005, 69 patients with BPH were surgically treated. Of these patients, 27 cases underwent open surgery, 22 transurethral resection of prostate（TURP） and 20 TURP plus transurethral incision of bladder neck （TUIBN）. There were no significant differences between the 3 groups in age, disease course, preoperative prostate weight and the excised pros!ate weight. The efficacy of open surgery, TRUP and TURP plus TUIBN were comparatively evaluated by international prostate symptom score （IPSS）, peak urinary flow rate（Qmax）, post void residual drine volume （PVR） and postoperative complications. Results After operation, the mean score of IPSS of patients which treated with open surgery decreased from （24. 6＋3. 8） to （15.1±3.8）, and the Qmax increased from （8.2±3.1） ml/s to （10.5±4.2） ml/s, and the PVR decreased from （96.0±36.0） ml to （54.0±27.0） ml. The IPSS of TURP group decreased from （22.3±5.6） to （11.7±2.7）, and the Qmax increased from （8.5±3.6） ml/s to （11.4±4.2） ml/s, and the PVR decreased from （105.0±39.0） ml/s to （32.0±14.0） ml/s. The IPSS of the TURP plus TUIBN group decreased from （23.6±5.7） to （6.4±2.3）, and the Qmax increased from （9.1±3.8）ml/s to （19.5±6.2） ml/s, and the PVR decreased from （98.0±37.0）ml to （8.0±5.0）ml. There were significant differences between the TURP plus TUIBN group and the other two groups in the IPSS, Qmax and PVR（P〈0.001）. Conclusion TURP plus TUIBN was an optimal treatment for the patients with BPH of small volume.

关 键 词：良性前列腺增生 膀胱颈出口梗阻 外科手术 小体积前列腺增生 术式疗效 膀胱出口梗阻 耻骨上经膀胱前列腺摘除 经尿道前列腺电切除术 国际前列腺症状评分 TUIBN 

分 类 号：R699[医药卫生—泌尿科学]