选择性前列腺切除联合膀胱颈切开治疗小体积前列腺增生的临床研究  

Selective transurethral prostatectomy combined with transurethral bladder neck incision in treatment of bladder outlet obstruction induced by small volume of prostatic hyperplasia

作　　者：李新[1] 张家华[1] 吴晓军[1] 沈文浩[1] 季惠翔[1] 鄢俊安[1] 熊恩庆[1] 金锡御[1] 宋波[1] 周占松[1] 

机构地区：[1]第三军医大学西南医院全军泌尿外科研究所,重庆400038

出　　处：《局解手术学杂志》2011年第2期130-132,共3页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆市自然科学基金项目(CSTC;2010BB5170)

摘　　要：目的探讨小体积前列腺增生引起膀胱颈出口梗阻的理想治疗方法。方法选择2009年7月至2010年6月,我科收治的小体积前列腺增生124例手术患者资料,其中单纯经尿道前列腺电切除术(TURP组)61例,选择性前列腺切除加膀胱颈切开术(STURP+TUIBN组)63例。对两组病人的一般状况、术中术后以及随访资料进行对照分析。结果两组病例在年龄、前列腺体积、术前国际前列腺症状评分(IPSS)、最大尿流率(Qm ax)方面比较无明显差异(P>0.05)。两组病人手术时间、前列腺切除质量、出血量无明显差异。两组患者术后IPSS评分比较无明显差异(P>0.05),但较术前均有明显降低(P<0.01)。两组术后出院时Qm ax较术前有明显改善(P<0.01),STURP+TUIBN组(24.33±7.64)mL/s较TURP组(18.46±5.79)mL/s明显好转(P<0.05)。两组患者术后6个月随访结果满意,其中STURP+TUIBN组Qm ax为(28.28±6.46)mL/s,更为理想(P<0.01)。TURP组中3例出现膀胱颈挛缩(BNC)和5例尿路感染,均较STURP+TUIBN组多。结论选择性前列腺切除联合膀胱颈切开术治疗小体积前列腺增生具有较好疗效,值得推广应用。Objective To explore the ideal treatment for bladder outlet obstruction（BOO） induced by small volume of benign prostatic hyperplasia（BPH）.Methods Totally 124 patients with BOO induced by small volume of BPH treated in our department from June 2009 to July 2010 were enrolled including 61 cases treated by transurethral prostatectomy（TURP group） and 63 cases treated by selective transurethral prostatectomy combined with transurethral bladder neck incision（STURP group plus TUIBN group）.The patient＇s general condition,references during and post operation as well as in the follow-up were analyzed comparatively.Results No significant difference in age,prostate volume,pre-operative international prostaric symptoms score（IPSS）,Omax was detected between TURP group and STURP plus TUIBN group（P〈0.05）.No significant difference in operation time,incised prostate volume,amount of bleeding was found between the two groups（P〉0.05）.No significant difference in post-operative IPSS was observed between the two groups,but it was markedly lowered after operation compared with that before operation（P〈0.01）.The maxium flow rate（Qmax） was improved in both groups at discharge（P〈0.01）,（24.33±7.64） ml/s in STURP plus TUIBN group,better than that of（18.46±5.79）mL/s in TURP group（P〈0.05）.The follow-up of 6 months after operation was satisfactory,Omax was（28.28±6.46）mL/s in STURP plus TUIBN group,better than that in TURP group（P〈0.01）.Three cases of bladder neck contracture and five cases of urine inflammation were found in TURP group.Conclusion STURP combined with TUIBN is the optimal treatment for the patients with small volume BPH.

关 键 词：良性前列腺增生 小体积前列腺 膀胱颈出口梗阻 外科手术 

分 类 号：R697.32[医药卫生—泌尿科学]