经尿道前列腺剜除术与耻骨上前列腺切除术治疗大体积前列腺增生的效果比较  

Comparison of effects of transurethral enucleation of prostate and suprapubic prostatectomy in the treatment of massive prostatic hyperplasia

作　　者：王贻兵[1] 王侠[1] Wang Yibing;Wang Xia(Department of Urology,Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning 110004,China)

机构地区：[1]中国医科大学附属盛京医院泌尿外科,沈阳110004

出　　处：《中国基层医药》2019年第20期2467-2470,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的比较经尿道前列腺剜除术( TUERP)与耻骨上前列腺切除术(SP)治疗大体积前列腺增生的临床效果.方法回顾性分析中国医科大学附属盛京医院2015年10月至2017年10月手术治疗的体积范围80~150 mL前列腺增生患者40例的临床资料,按手术方法分为两组,TUERP组20例,采用TUERP治疗;SP组20例采用SP治疗.测量大体积前列腺长度及分布情况;比较两组手术前后血红蛋白、膀胱冲洗时间、手术时间、留置尿管时间、最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、前列腺特异抗原(PSA)、残余尿量(PVR)及并发症发生率.结果测量发现,体积范围80~150 mL的大体积前列腺增生患者,前列腺窝内长度基本在5 cm以内.术后,TUERP组血红蛋白下降程度、膀胱冲洗时间、留置尿管时间、手术后并发症发生率分别为(7.9 ±2.3)g/L、(42.5 ±3.6)h、(5.3 ±1.1)d、15%(3/20);SP组分别为(14.2 ±4.4)g/L、(62.6 ± 6.0)h、(7.8 ±0.8)d、50%(10/20),两组均差异有统计学意义( t=-5.7、-12.8、-8.6,χ^2=5.6,均P<0.05);两组手术时间及术后Qmax、IPSS、PSA、PVR均差异无统计学意义(均P>0.05).结论 TUERP治疗大体积前列腺增生,术后排尿改善与PSA下降程度与SP相似,而且止血效果好,术后并发症少,恢复快.Objective To compare the clinical effects of transurethral prostatectomy(TUERP) and suprapubic prostatectomy(SP) in the treatment of massive prostatic hyperplasia. Methods The clinical data of 40 patients with benign prostatic hyperplasia(BPH) with a volume range of 80-150 mL from October 2015 to October 2017 in Shengjing Hospital of China Medical University were retrospectively analyzed.They were divided into two groups: TUERP group(20 cases) and SP group(20 cases). The length and distribution of large prostate were measured.The degree of hemoglobin decrease, bladder irrigation time, operation time, indwelling catheter time, maximum urine flow rate(Qmax), international prostate symptom score(IPSS), prostate specific antigen(PSA), residual urine volume(PVR) and the incidence of complications were compared between the two groups before and after operation. Results It was found that the length of the prostatic fossa was less than 5 cm in patients with large prostatic hyperplasia whose volume ranged from 80 to 150 mL.After operation, the degree of hemoglobin decrease, bladder irrigation time, indwelling catheter time and the incidence of complications in the TUERP group were (7.9±2.3)g/L,(42.5±3.6)h,(5.3±1.1)d, 15%(3/20), respectively, while in the SP group were (14.2±4.4)g/L,(62.6±6.0)h,(7.8±0.8)d and 50%(10/20), respectively, there were statistically significant differences between the two groups(t=-5.7,-12.8,-8.6,χ2=5.6, all P<0.05). There were no statistically significant differences in operation time, Qmax, IPSS, PSA and PVR between the two groups(all P>0.05). Conclusion After TUERP treatment of large prostate hyperplasia, the improvement of urination and the decrease of PSA is similar to SP, and the hemostasis effect is good, the complications are less and the recovery is faster.

关 键 词：前列腺增生 前列腺切除术 经尿道前列腺切除术 血红蛋白类 投药 膀胱内 手术后并发症 

分 类 号：R699.8[医药卫生—泌尿科学]