经尿道等离子前列腺剜除术对老年良性大体积前列腺增生患者前列腺症状评分和生活质量的影响  

Impact of transurethral plasmamakinetic enucleation surgery in treating elderly patients with benign mass hyperplasia on prostate symptom score and life quality

作　　者：严博泉[1] 李燕玲[2] 刘少青[3] Yan Boquan1, Li Yanling2,Liu Shaoqing2.(1 （1）Department of Urology, （2Department of Center Oper- ating Room, Qingdao Municipal Hospital, Qingdao 266091, China ; 2 Department of Urology, Affiliated Hospital of Binzhou Medical College, Binzhou 256603, China)

机构地区：[1]青岛市市立医院(东院)泌尿外科,山东青岛266091 [2]青岛市市立医院(东院)中心手术室,山东青岛266091 [3]滨州医学院附属医院泌尿外科,山东滨州256603

出　　处：《国际泌尿系统杂志》2018年第2期220-224,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨经尿道等离子前列腺剜除术（transurethralplasmakineticenucleationofprostate，TUPKEP）对老年良性大体积前列腺增生患者的前列腺症状评分和生活质量的影响。方法选取2012年3月至2014年9月收治在本院的老年良性大体积前列腺增生患者128例，其中78例患者采用TUPKEP治疗为TUPKEP组，50例患者采用经尿道前列腺电切术（transurethralresectionofprostate，TURP）治疗为TURP组。比较两组手术情况、治疗前后的国际前列腺症状评分（IPSS）、生存质量评分（SF-36）、不良反应和并发症发生情况。结果与TURP组比较，TUP-KEP组留置尿管时间和术后住院时间均缩短，手术时间延长，术中出血量和术后膀胱剩余尿量减少，前列腺组织切除量和最大尿流率增加（P〈0．05）。TUPKEP组治疗后1年的IPSS得分为（5．23±1．14）分，低于TURP组的（12．08±2．08）分，且TUPKEP组和TURP组治疗后的IPSS得分均较治疗前降低（P〈0．05）。TUPKEP组治疗后1年的生理功能、生理职能、躯体疼痛、总体健康、社会功能、活力、情感职能和精神健康8个维度的生存质量得分均高于TURP组，且TUP-KEP组和TURP组治疗后的生存质量得分则均高于治疗前（P〈0．05）。TUPKEP组消化道反应、感染、尿道狭窄、低钠血症、输血、直肠损伤、TURS等不良反应和并发症总发生率为26．92％（21／78），TURP组不良反应和并发症总发生率为40．00％（20／50），两组比较差异无统计学意义（P〉0．05）。结论TUPKEP治疗老年良性大体积前列腺增生患者的手术创伤小，可有效改善症状，有利于患者术后恢复和生存质量的改善，且不良反应和并发症发生少，具有良好的可行性和安全性，值得临床推广使用。Objective To evaluate the impact of transurethral plasmamakinetic enucleation surgery（TUPKEP） in treating elderly patients with benign mass hyperplasia on prostate symptom score and life quality. Methods From March 2012 to September 2014, 128 elderly patients benign mass hy- perplasia in our hospital were selected and 78 patients who were treated with TUPKEP was taken as TUPKEP group while the other 50 patients who underwent transurethral resection of prostate （TURP） was taken as TURP group. Operation conditions, international prostate symptom score （IPSS） and quality of life score （ SF - 36 ） and adverse reactions and complications of two groups before and after treatment were compared. Results Compared with TURP group, urinary catheter placing time and postoperative hospital stay time of TUPKEP group were shorter, the operation time of TUPKEP groupwas longer, intraoperative blood loss and postoperative bladder residual urine volume of TUPKEP group were reduced, and prostate tissue removal and the maximum urine flow rate of TUPKEP group were in- creased （ P 〈 0.05 ）. IPSS score of TUPKEP group postoperative one year was （ 5.23 ±1.14 ） points, which was lower than the （ 12.08 ±2.08） points of TURP group, and IPSS score of the TUPKEP group and TURP group after treatment were lower than that of before treatment （ P 〈 0.05 ）. Hysiologi- cal function, physiological function, body pain, general health, social function, dynamic, emotional functions and mental health eight dimensions of life quality scores of TUPKEP group postoperative one year were also higher than that of TURP group, and life quality score of TUPKEP group and TURP group postoperative 1 year were higher than that of before treatment （ P 〈 0.05 ）. Total incidence of gastrointestinal tract reaction, infection, urethral stricture, hyponatremia, blood transfusion, rectum in- jury, transurethral resection syndrome （TURS） and other adverse reaction and complications of TUP- KEP group was 26.92% （ 21/78 ） ,

关 键 词：前列腺增生 经尿道前列腺切除术 生活质量 

分 类 号：R699.8[医药卫生—泌尿科学]