经直肠前列腺穿刺活检术后经尿道前列腺电切术时机的探讨  

A Discussion on the TURP Opportunity After Transrectal Prostate Biopsy

作　　者：庄红雨[1] 彭涛[1] 姜永光[1] 

机构地区：[1]首都医科大学附属北京安贞医院泌尿外科,北京100029

出　　处：《中国微创外科杂志》2017年第9期800-802,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：北京市自然科学基金(No:7172068)

摘　　要：目的探讨经直肠前列腺穿刺活检后经尿道前列腺电切术(transurethral resection of prostate,TURP)的时机。方法 2013年9月~2015年9月,经直肠前列腺穿刺活检后行TURP 60例,按时间先后分为A、B组各30例,2组年龄、前列腺特异抗原(prostate specific antigen,PSA)、前列腺体积、血红蛋白及国际前列腺症状评分(international prostate symptom score,IPSS)无统计学差异。A、B组分别于穿刺后1周及4周行TURP,记录手术时间、切除前列腺重量、术中失血量、术后膀胱冲洗时间及术后3个月IPSS。结果 B组手术时间、术中出血量、术后膀胱冲洗时间及术后3个月IPSS均显著低于A组[(58.3±6.0)min vs.(62.0±3.3)min,t=2.952,P=0.005;(154.1±15.8)ml vs.(167.4±29.5)ml,t=2.181,P=0.035;(19.2±0.8)h vs.(20.6±2.3)h,t=3.034,P=0.004;(18.3±2.5)分vs.(20.3±2.0)分,t=3.419,P=0.001],切除前列腺重量明显高于A组[(37.1±4.0)g vs.(33.3±7.8)g,t=-2.341,P=0.024]。结论经直肠前列腺穿刺活检术后4周再行TURP,可以显著增加切除前列腺重量,减少术中出血量,缩短手术时间及术后膀胱冲洗时间,更显著地改善排尿症状。如无特殊情况,建议穿刺后4周行TURP。Objective To discuss the opportunity of transu rethra l resection of prostate （TURP ） after tran s re c ta l prostate biopsy. Methods We analyzed 60 cases of benign prostatic hyperplasia （ BPH ） who underwent TURP after tran s rectal prostate biopsy from September 2013 to September 2015. All the patients were divided into either group A or group B in chronological order, with 30 cases in each group. There were no significant differences in age, prostate specific antigen （ PSA） , prostate volume, hemoglobin level, and international prostate symptom score （IPSS） between the two groups. The group A and group B were treated by TURP at 1 week and 4 weeks after transrectal prostate biopsy, respectively. The parameters including operation time, excised prostate weight, intraoperative total blood loss, bladder irrigation time, and IPSS at 3 months after operation were recorded. Results The operation time, intraoperative total blood loss, bladder irrigation time, and IPSS in the group B were significantly lower than those in the group A [（58.3±6.0） min vs. （62. 0 ± 3. 3） min,t = 2.952, P=0. 005 ; （154.1±15.8） mlvs. （167.4±29.5） ml, t =2. 181,t= 0.035; （19. 2 ±0. 8） h vs. （20. 6 ±2.3） h,t = 3.034,t= 0 .0 0 4 ; （1 8 . 3 ± 2 . 5 ） points vs. （2 0 . 3 ± 2 . 0 ） p o i n t s , t =3. 419 , P = 0. 001 ] . The excised prostate weight in the group B was significantly higher than that in the group A [（37.1±4.0） g vs. （33.3±7.8） g, t = - 2. 341,P = 0. 024 ] . Conclusions TURP performed a t 4 weeks after transrec ta l prostate biopsy can significantly increase the excised prostate weight, reduce intraoperative total blood loss volume, shorten the operation time and postoperative bladder irrigation time, and improve urinary symptoms. In brief, we recommend that TURP be executed at 4 weeks after transrectal prostate biopsy.

关 键 词：经直肠前列腺穿刺活检 经尿道前列腺电切术 时机 

分 类 号：R699.8[医药卫生—泌尿科学]