四种前列腺支架置入术治疗高危良性前列腺增生的疗效观察  

Clinical Effectiveness of Four Approaches for Prostate Stent Placement for Treating Benign Prostatic Hyperplasia

作　　者：杨文增[1] 张萌[1] 齐丽丽[1] 王全胜[1] 郭景阳[1] 

机构地区：[1]河北大学附属医院泌尿外科,河北省保定市071000

出　　处：《中国全科医学》2011年第9期1008-1010,共3页Chinese General Practice

摘　　要：目的观察不同前列腺支架置入方法治疗高危良性前列腺增生的疗效,评价不同方法的优缺点。方法选取52例良性前列腺增生患者,其中8例采用膀胱小切口前列腺支架置入,12例采用膀胱镜直视下前列腺支架置入,5例采用B超联合膀胱镜支架置入,27例采用B超引导前列腺支架置入术。前列腺尿道长度为4.0～5.6 cm,平均5.0 cm。观察4种支架置入术后患者的国际前列腺症状评分(IPSS)、最大尿流率、剩余尿量,比较4种支架置入术患者的手术时间及住院时间,随访术后不良反应。结果 52例患者均一次支架置入成功,B超引导前列腺支架置入术患者的手术时间及住院时间较膀胱小切口前列腺支架置入、膀胱镜直视下前列腺支架置入、B超联合膀胱镜支架置入患者显著缩短,差异有统计学意义(P<0.05)。随访10～16个月,其中2例术后改膀胱造瘘,1例取出支架行耻骨上前列腺摘除术。结论 B超引导前列腺支架置入方法操作简便,手术时间短,且治疗效果确切,优于其他几种前列腺支架置入方法。Objective To observe the effectiveness of different approaches for prostate stent placement in treating high-risk benign prostatic hyperplasia,so as to evaluate their advantages and disadvantages. Methods Totally 52 patients with benign prostatic hyperplasia were enrolled in this study.Among these patients,prostate stent was placed via a small incision at bladder in 8 patients,directly under cystoscope in 12 patients,under the assistance of both ultrasound and cystoscope in 5 patients,and under the guidance of ultrasound in 27 patients.The length of prostatic urethra ranged 4.0 cm to 5.6 cm（mean：5.0 cm）.After the stents were placed,the postoperative International Prostate Symptom Score（IPSS）,maximum urine flow rate,and residual urine output（RU） were measured.The lengths of surgery and hospitalization were compared.The post-operative adverse reactions were followed. Results Stents were susccessfully placed in the first attempt in all these 52 patients.The lengths of surgery and hospitalization were significantly shorter in ultrasound-guided group than in the other three groups（P0.05）.A 10~16-month follow-up showed that two patients underwent cystostomy and one patient received suprapubic transvesical prostatectomy after the stent was removed. Conclusion Ultrasound-guided prostate stent placement is a relatively simple procedure with short surgical duration and promising treatment effectiveness,and therefore is superior to the other three approaches.

关 键 词：前列腺增生 前列腺支架置入 膀胱镜 B超检查 介入性 

分 类 号：R697.32[医药卫生—泌尿科学]