老年前列腺癌患者行根治性切除术保留膀胱颈对早期控尿的影响及安全性  

Effects and safety for early urinary continence of elderly prostate cancer patients treated by laparoscopic radical prostatectomy with bladder neck preservation

作　　者：滕润玲 任晓燕[1] 

机构地区：[1]天津市第五中心医院消毒供应中心

出　　处：《中国生化药物杂志》2017年第7期415-418,共4页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的探究老年前列腺癌患者腹腔镜下行根治性前列腺切除术保留膀胱颈对术后早期控尿功能的影响和安全性。方法回顾性探究分析2012年4月~2013年5月期间内对123例老年前列腺癌老年患者行腹腔镜根治性前列腺切除手术的临床资料,包括手术时间、术中出血量、手术切缘阳性率、早期控尿等指标。其中保留膀胱颈患者有56例（A组）,不保留膀胱颈有67例（B组）。不良事件依据国家癌病组织（National Cancer Institute,NCI）通用毒性評分表（Common Toxicity Criteria）对尿失禁进行分级;通过日尿垫用量情况评估患者术后控尿情况;最后详细记录患者术后当日及7天、3个月、6个月的控尿情况。结果 A、B2组患者在体质指数、前列腺体积、术前血清PSA水平以及术前Gleason评分,差异无统计学意义。2组患者当中术后分别出现5例和7例手术切缘阳性,且术后A、B2组分别有6例和9例出现漏尿。A、B2组患者尿管拔除时和此后的7天、1个月、3个月时尿失禁0级患者数以及控尿率,差异具有统计学意义（P〈0.05）。结论老年前列腺癌患者行根治性前列腺切除术时保留膀胱颈有利于早期控尿,其安全性和可行性相对较高,值得推广。Objective To explore the effects and safety of early urinary continence for elderly prostate cancer patients treated with laparoscopic radical prostatectomy with bladder neck preservation. Methods Retrospectively analyze the datas for 123 elderly prostate cancer patients treated with laparoscopic radical prostatectomy with bladder neck preservation,including operative time,blood lose,margin status and early continence status,etc from group A（ 56 cases） and group B（ 67 cases）. Classify the urinary incontinence through Common Toxicity Criteria of National Cancer Institute while evaluate the postoperative urinary continence for patients by number of daily pads usage. Lastly,record the urinary continence at the very day,7 days,1and 3 months in detail. Results There were no significant differences in body mass index,prostate volume,preoperative serum PSA level and preoperative Gleason score between the two groups. 2 cases of patients were postoperative 5 cases and 7 cases of surgical margin positive,and postoperative A,B two groups were 6 cases and 9 cases of leakage of urine. The number of urinary incontinence 0 and urinary incontinence were significantly different between the two groups（ P 〈0. 05）. Conclusion Elderly prostate cancer patients treated with radical prostatectomy with bladder neck preservation,is useful for early urinary continence,which is available and safe to be generalized.

关 键 词：前列腺癌 腹腔镜根治性前列腺切除术 术后控尿 

分 类 号：R6[医药卫生—外科学]