三种手术方法治疗前列腺增生症的疗效研究  

Effect of three surgical treatment methods on prostate hyperplasia

作　　者：凌锋[1,2] 郑少波[1] 李虎林[1] 刘春晓[1] 

机构地区：[1]南方医科大学附属珠江医院泌尿外科,广东广州510280 [2]南方医科大学附属中山博爱医院泌尿外科,广东中山528403

出　　处：《兰州大学学报（医学版）》2015年第4期27-31,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：广东省自然科学基金项目(S2013010014644)

摘　　要：目的探讨3种手术方法治疗前列腺增生症的疗效。方法选取进行外科治疗的前列腺增生症患者150例,按照患者接受的手术方式分为经尿道保留前列腺前叶等离子剜除术组(保留组)、经尿道前列腺等离子剜除术组(剜除组)、经尿道前列腺电切术组(电切组),每组50例。术前均行直肠指诊、经直肠前列腺B超、尿动力学检查及相关实验室检查,并进行前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Q_(max))和残余尿量(RUV)评价。记录手术一般情况、并发症情况以及术后12个月后的IPSS、QOL、Q_(max)、RUV。结果电切组的手术时间、术中出血量、膀胱冲洗时间、导尿管留置时间、术后住院时间高于保留组和剜除组(P<0.001)。3组患者术后IPSS、QOL、Q_(max)和RUV较术前均明显改善(P<0.001),术后12个月Q_(max)增加(P<0.001),RUV减少(p=0.009),QOL改善(P<0.001)。结论 3组患者的治疗效果因手术方式不同而有差异,疗效指标均较术前有明显改善。剜除术创伤更小,安全可靠,更易恢复。保留前列腺前叶剜除术安全性和有效性相对较好。Objective To investigate the therapeutic effect of three surgical treatment methods for prostate hyperplasia. Methods Patients with prostate hyperplasia were divided into the anterior reserved transurethral enucleative resection group （reserved group）, transurethral enucleative resection group （enucleative group） and transurethral prostate electrocision （electrocision group） （50 cases in each group） according to the surgical procedure. Preoperatively the patient underwent rectal exam, transrectal prostate ultrasound, urodynamic test and related laboratory tests. International prostate symptom score （IPSS）, quality of life score （QOL）, maximum urinary flow rate （Qmax） and residual urine volume （RUV） were evaluated. The general surgical situation and the complications were recorded. All the patients were followed up for IPSS, QOL, Qmax, RUV after 12 months. Results The operation time, intraoperative blood loss, bladder douching time, catheter indwelling time and postoperative hospital stay in the electrocision goup were significantly higher than those in other groups （ P 〈 0.001）. PSS, QOL, Qmax and RUV were significantly improved in the 3 groups postoperatively （P 〈 0.001） with the increase of Qmax （P 〈 0.001）, the decrase ofRUV （ P = 0.009）, the improvement of QOL （P 〈 0.001）. Conclusion There were differences in the treatment effect of different surgical methods on the 3 groups patients. All the therapeutic evaluation indexes are significantly improved compared with preoperativeindexes. Enucleation is less invasive, safe and reliable resulting in patient quick recovery while the anterior reserved enucleation seems to be relatively safe and effective.

关 键 词：前列腺增生 剜除术 电切术 预后 

分 类 号：R697.32[医药卫生—泌尿科学]