超声引导下经尿道前列腺水囊扩开术治疗良性前列腺增生的1年疗效分析  

One-year effect of ultrasound guided transurethral balloon dilation of prostate for the treatment of benign prostatic hyperplasia

作　　者：刁英智[1] 任向宏[1] 张明华[1] 蒙学兵[1] 谷亚明[1] 刘红雷[1] 郭应禄[2] 

机构地区：[1] 首都医科大学密云教学医院泌尿外科, 北京101500 [2] 北京大学第一医院泌尿外科

出　　处：《中华泌尿外科杂志》2014年第6期457-460,共4页Chinese Journal of Urology

摘　　要：目的 探讨经直肠超声引导下前列腺水囊扩开术（transurethral balloon dilation of the prostate,TUDP）治疗良性前列腺增生（BPH）的有效性及安全性. 方法 回顾性分析2011年11月至2012年11月23例经直肠超声引导下TUDP治疗的BPH患者的临床资料.年龄65 ～ 85岁,平均75岁.16例术前留置导尿.内囊扩张前列腺尖部及膜部尿道,外囊扩张前列腺部尿道及膀胱颈.随访患者术后1、3、6、12个月的主观指标（IPSS评分、QOL评分）及客观指标（Qmax、残余尿量）等.结果 手术时间30～ 165 min,术中出血量5～ 50 ml.2例术后出现尿潴留.余21例术后1、3、6、12个月IPSS评分分别为（10.4±4.2）、（8.7±3.2）、（9.5±4.6）、（8.3±1.5）分,与术前（22.0±7.2）分比较差异均有统计学意义（P＜O.05）;QOL评分分别为（2.1±1.1）、（1.6±1.0）、（1.8±1.1）、（1.6±1.0）分,与术前（4.9±0.9）分比较差异均有统计学意义（P＜0.05）;Qmax分别为（10.5±3.4）、（12.4±4.2）、（10.9±3.9）、（12.7±4.6） ml/s,与术前（1.9± 1.9） ml/s比较差异均有统计学意义（P＜0.05）;残余尿量均为0 ml.术后1、2、3个月发生尿失禁者分别为5、4、2例,术后4个月无尿失禁患者.术后发生附睾炎3例.结论 经直肠超声引导下TUDP治疗BPH安全、有效,费用低廉,尤其适合基层医院开展.Objective To investigate the efficacy and safety of transrectal ultrasound guided transurethral balloon dilation of the prostate （TUDP） for the treatment of benign prostatic hyperplasia （BPH）.Methods A total of 23 men with BPH who had undergone TUDP were retrospectively analyzed,including 16 men with indwelling urinary catheters before the operation.During the TUDP,the prostatic apex and membranous urethra were dilated by inner balloon,and the prostatic urethra and bladder neck were dilated by outer balloon.The patients were followed up at the 1st,3rd,6th and 12th month after the operation,and the observation parameters included subjective symptoms,such as international prostatic symptom score （IPSS） and quality of life （QOL） score,and objective parameters,such as maximum flow rate （Qmax） and post-void residual （PVR）.Results The operation time was 30-165 min,and the intraoperative hemorrhage volume was 5-50 ml.The IPSS scores at 1st,3rd,6th and 12th month after the operation were 10.4± 4.2,8.7±3.2,9.5±4.6 and 8.3±1.5 respectively,which were significantly decreased in comparison to the IPSS score （22.0±7.2） before the operation （P〈0.05）.The QOL scores at 1st,3rd,6th and 12th month after the operation were 2.1±1.1,1.6±1.0,1.8±1.1 and 1.6±1.0 respectively,which were significantly improved in comparison to the QOL score （4.9±0.9） before the operation （P〈0.05）.The Qmax at 1st,3rd,6th and 12th month after the operation were （10.5±3.4）,（12.4±4.2）,（10.9±3.9） and （12.7±4.6） ml/s respectively,which were significantly increased in comparison to the Qmax（1.9± 1.9 ml/s） before the operation （P〈0.05）.There were 5,4,2 cases of urinary incontinence at the 1st,2nd and 3rd month after the operation,but they recovered at the 4th month follow-up.Besides,there were 3 cases suffered from epididymitis.Conclusion Transrectal ultrasound guided TUDP is a safe,effective and cheap option for the treatment of BPH,especially for the primary hospitals.

关 键 词：超声引导下 前列腺水囊扩开术 前列腺增生 治疗结果 

分 类 号：R699.8[医药卫生—泌尿科学]