肾移植受者良性前列腺增生的手术治疗和临床研究  

Surgery treatment and clinical research in renal transplant recipients with benign prostatic hyperplasia

作　　者：周萃星[1] 许贤林[1] 丁涛[1] 范敏[1] 

机构地区：[1]苏州大学附属第三医院泌尿外科,江苏常州213003

出　　处：《中国医师进修杂志》2016年第7期593-596,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的：研究肾移植受者良性前列腺增生（BPH）的临床表现和手术治疗效果。方法选取2013年1月至2015年5月肾移植受者因BPH行经尿道前列腺切除术（TURP）治疗5例患者（肾移植组），与同期普通BPH行TURP治疗15例患者（普通对照组），对术前常规检查、尿流动力学、性激素等指标进行对比，并观察肾移植受者行手术治疗后的效果。结果两组术前血红蛋白、总蛋白、尿素氮、肌酐、前列腺体积、残余尿、最大尿流率比较差异均无统计学意义（P＞0.05）；肾移植组睾酮水平低于普通对照组[（3.5±1.2）mmol/L比（5.5±2.2）mmol/L]，雌二醇水平高于普通对照组[（49.6±13.8）mmol/L比（40.5±16.4）mmol/L]，差异均有统计学意义（P＜0.05）。肾移植组手术前后血红蛋白、总蛋白、尿素氮、肌酐水平比较差异均无统计学意义（P＞0.05）。两组术后血红蛋白、总蛋白、尿素氮、肌酐水平比较差异均无统计学意义（P＞0.05）。肾移植组术前生命质量指数（QOL）评分5分4例，6分1例。术后1个月0分3例，1分2例。结论合并BPH的肾移植受者在充分的术前准备和手术评估下，与普通BPH患者一样可通过TURP治疗改善尿路梗阻症状，均能取得满意的治疗效果。Objective To study the clinical manifestations and surgical treatment in renal transplant recipients with benign prostatic hyperplasia （BPH）. Methods From January 2013 to May 2015, 5 patients of kidney transplant recipients who suffered from BPH for transurethral resection of prostate （TURP） treatments were enrolled （kidney transplant recipients group） and 15 patients with the same surgical treatments during the same peoriod were enrolled too （common control group）. The routine examination, urodynamic, sex hormone levels and and the clinical efficacy were observed. Results The levels of hemoglobin, total protein, urea nitrogen, creatinine, prostate volume , residual urine and maximum flow rate （Qmax） before operation between two groups had no significant differences （P〉0.05）. The level of testosterone in kidney transplant recipients group was significantly lower than that in common control group： （3.5 ± 1.2） mmol/L vs. （5.5 ± 2.2） mmol/L, P 〈 0.05. The level of estradiol in kidney transplant recipients group was significantly higher than that in common control group：（49.6 ± 13.8） mmol/L vs. （40.5 ± 16.4） mmol/L, P 〈 0.05. In kidney transplant recipients group, the levels of hemoglobin, total protein, urea nitrogen, creatinine before and after operation had no significant differences （P〉0.05）. After operation, the levels of hemoglobin, total protein, urea nitrogen, creatinine in two groups had no significant differences （P〉0.05）. In kidney transplant recipients group, the quality of life （QOL） score before operation was 5 scores in 4 cases and 6 scores in 1 case, and those after operation were zero in 3 cases and 1 score in 2 cases. Conclusions Under the sufficient preoperative preparation and assessment, the renal transplant recipients with BPH patients can improvethe symptoms of urinary obstruction and obtain satisfactory clinical efficacy as common BPH patients.

关 键 词：肾移植 前列腺增生 经尿道前列腺切除术 

分 类 号：R699[医药卫生—泌尿科学]