微创术式与综合药物保守治疗对老年良性前列腺增生症患者症状及控尿功能的影响  

Effects of minimally invasive surgery and comprehensive drug conservative therapy on the urinary continence and urine control of elderly patients with benign prostatic hyperplasia

作　　者：王涛[1] 王刚[1] 张建勋[1] 刘安[1] 高旭[1] WANG Tao;WANG Gang;ZHANG Jianxun;LIU An;GAO Xu(Department of Urology,Yan＇an People＇s Hospital,Yan＇an 716000,Shaanxi,China)

机构地区：[1]延安市人民医院泌尿外科,陕西延安716000

出　　处：《中国性科学》2018年第10期33-37,共5页Chinese Journal of Human Sexuality

摘　　要：目的:探讨微创术式与综合药物保守治疗对老年良性前列腺增生症(benign prostatic hyperplasia,BPH)患者症状及控尿功能的影响。方法:选择2014年2月至2016年2月延安市人民医院诊治的160例老年BPH患者为研究对象,向患者讲解微创手术与药物保守治疗方案,在参考患者个人意愿的基础上,按照随机数表法将其分为研究组(n=68)与对照组(n=92)。研究组采用微创术即经尿道前列腺切除术(transurethral resection of the prostate,TURP),对照组采用坦索罗辛联合度他雄胺治疗。比较两组患者控尿能力、前列腺症状以及性功能,评估生活质量,统计不良反应与并发症发生率。结果:研究组患者治疗6个月后残余尿量、前列腺症状评分(IPSS)、勃起功能评分(IIEF-5)分别为(10. 25±1. 83) ml、(7. 82±1. 48)分、(11. 04±2. 17)分,显著低于对照组患者的(14. 06±2. 74) ml、(9. 75±1. 71)分、(14. 16±2. 69)分(P <0. 05);研究组患者的最大尿流率、生活质量(BPHQOLS)总分分别为(22. 19±4. 04) ml/s、(269. 11±48. 54)分,显著高于对照组患者的(16. 40±2. 97) ml/s、(252. 36±45. 67)分(P <0. 05)。结论:微创手术与综合药物保守治疗均为老年BPH患者的有效治疗方案。TURP在症状缓解与控尿功能改善上优于综合药物保守治疗,但可能引起多种并发症,对患者勃起功能产生一定影响。Objective： To study the effects of minimally invasive surgery and comprehensive drug conservative therapy on the urinary continence and sexual function of elderly patients with benign prostatic hyperplasia（ BPH）. Methods： 160 patients with BPH treated in Yan＇an People＇s Hospital from February 2014 to February2016 were selected as study subjects. The minimally invasive surgery and comprehensive drug conservative therapy were explained to patients. Referring to the personal willingness of patients,they were randomly divided into minimally invasive group（ n = 68） and conservative group（ n = 92）. The minimally invasive group was treated with transurethral resection of the prostate（ TURP） while the conservative group was treated with tamsulosin and dutasteride. The urinary continence,symptoms of the prostate and sexual function were compared between the two groups,and the quality of life was evaluated. The incidence rates of adverse reactions and complications were statistically analyzed. Results： The residual urine volume,the international prostatic symptom score（ IPSS） and erectile function score（ IIEF-5） of the minimally invasive group after 6 months of treatment [（ 10. 25 ± 1. 83） ml,（ 7. 82 ±1. 48）,（ 11. 04 ± 2. 17） ] were significantly less or lower than those of the conservative group [（ 14. 06 ± 2. 74）ml,（ 9. 75 ± 1. 71）,（ 14. 16 ± 2. 69） ]（ P〈0. 05）,while the maximum flow rate and quality of life（ BPHQOLS）score [（ 22. 19 ± 4. 04） ml/s（ 269. 11 ± 48. 54） ] were significantly higher than those of conservative group[（ 16. 40 ± 2. 97） ml/s,（ 252. 36 ± 45. 67） ]（ P〈0. 05）. Conclusions： Minimally invasive surgery and drug conservative therapy are effective treatments for elderly patients with BPH. TURP is better than conservative therapy in relieving symptoms and improving urinary continence,but it may cause many complications and has certain effect on the erectile function.

关 键 词：前列腺增生症 老年 经尿道前列腺切除术 坦索罗辛 度他雄胺 

分 类 号：R699.8[医药卫生—泌尿科学]