移行带指数对经尿道前列腺电切术疗效的影响分析  

Effect of transition zone index on the outcome after transurethral resection of prostate

作　　者：苏志勇 刘洪明 田野[2] 杨兵 罗光恒 Su Zhiyong;Liu Hongming;Tian Ye;Yang Bing;Luo Guangheng(Guizhou Medical University,Guiyang 550004 China;Department of Urology,People′s Hospital affiliated to Guizhou Medical University,Guiyang 550002,China)

机构地区：[1]贵州医科大学,贵阳550004 [2]贵州省人民医院泌尿外科,贵阳550002

出　　处：《中华医学杂志》2020年第6期452-455,共4页National Medical Journal of China

基　　金：国家自然科学基金(81860143);贵州省卫计委基金(gzwjkj2017-1-032)。

摘　　要：目的探讨分析术前移行带指数(TZI)对经尿道前列腺电切术(TURP)患者疗效的影响。方法对贵州省人民医院2016年1月至2018年9月收治的206例行TURP患者进行回顾性分析,术前均行经直肠超声(TRUS)检查测定前列腺体积(TPV)及移行带体积(TZV),根据移行带指数(TZV/TPV)大小,分为A组(TZI<0.5)、B组(TZI≥0.5)两组。术后6个月随访采集国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿量(PVR)资料对两组进行比较,而IPSS被细分为排尿期症状评分(IPSS-v)和储尿期症状评分(IPSS-s),分析两组手术前后IPSS、IPSS-v、IPSS-s、QOL、Qmax、PVR的变化。以手术前后IPSS评分之比(术后/术前:%IPSS)、手术前后QOL之差(术前-术后:△QOL)、手术前后Qmax之差(术前-术后:△Qmax)作为评估术后疗效指标,利用Pearson直线相关性分析判断TZI与%IPSS、△QOL以及△Qmax之间的相关性。结果A组共纳入126例,B组80例。(1)比较两组术前临床资料,年龄、IPSS、IPSS-v、IPSS-s、QOL、Qmax、PVR差异均无统计学意义(P>0.05),B组TPV(74.57±29.25)ml明显大于A组(46.25±24.56)ml,P<0.001。比较两组术后随访结果,IPSS-s(P=0.079)、QOL(P=0.71)、PVR(P=0.651)差异无统计学意义,但术后IPSS、IPSS-v、Qmax[A组:B组(8.50±5.75)与(6.38±4.36),(4.03±3.75)与(2.63±2.5),(16.54±4.43)ml/s与(18.94±4.84)ml/s,均P<0.05],组间差异均有统计学意义。(2)不论是A组还是B组,患者术后IPSS、IPSS-v、IPSS-s、QOL、Qmax及PVR与术前分别比较均差异有统计学意义(均P<0.01)。(3)Pearson直线相关性分析发现TZI与△Qmax(r=0.32,P<0.01)间存在显著正相关,与%IPSS(r=-0.22,P<0.01)间存在较弱的负相关性,而TZI与△QOL(r=0.08,P=0.238)间不存在相关性。结论TURP疗效与TZI可能存在一定相关性,且TZI≥0.5的患者,TURP疗效可能更好。Objective To investgate the effect of properative transitional zone index(TZI)on the outcome of transurethral resection of prostate(TURP).Methods A retrospective analysis was performed on 206 patients with TURP who were admitted to our hospital from January 2016 to September 2018.All patients underwent transrectal ultrasound(TRUS)to determine the total prostate volume(TPV)and the transition zone volume(TZV).Patients were divided into two groups according to TZI(TZV/TPV)(group A:TZI<0.5,group B:TZI≥0.5).We collected data 6-months after surgery including international prostate symptom score(IPSS),quality of life score(QOL),maximum flow rate(Qmax),and postvoiding residue(PVR)to compare the difference of the postoperative outcome of two groups,while the IPSS was subdivided into voiding(IPSS-v)and storage(IPSS-s)symptoms,and the changes of IPSS,IPSS-v,IPSS-s,QOL,Qmax and PVR before and after surgery were analyzed.The treatment efficacy was determined as the changes of IPSS(post/preoperative IPSS:%IPSS),QOL(preoperative QOL-postoperative QOL:ΔQOL)and Qmax(preoperative Qmax-postoperative Qmax:ΔQmax).Pearson linear correlation analysis was employed to estimate the correlation of TZI and%IPSS,ΔQOL andΔQmax,respectively.Results A total of 126 patients were in Group A,and 80 patients were in group B.1.The preoperative clinical data of the two groups were compared.There were no significant differences regarding age,IPSS,IPSS-v,IPSS-s,QOL,Qmax,and PVR between two groups(all P>0.05).However,the TPV of patients in group B(74.57±29.25)ml was significantly larger than that in group A(46.25±24.56)ml,P<0.001.While the postoperative follow-up outcomes of the two groups were compared,we found that IPSS-s(P=0.079),QOL(P=0.710),and PVR(P=0.651)were not statistically different between the two groups,but the postoperative IPSS,IPSS-v,and Qmax(8.50±5.75 vs 6.38±4.36,4.03±3.75 vs 2.63±2.5,and(16.54±4.43)ml/s vs(18.94±4.84)ml/s,all P<0.05)were significantly different between the two groups.2.Postoperative IPSS,IPSS-v,IPSS-s,QO

关 键 词：良性前列腺增生 经尿道前列腺电切术 移行带指数 疗效 

分 类 号：R699[医药卫生—泌尿科学]