TURP对逼尿肌收缩力低下患者的临床疗效分析  

The clinical effect of TURP in patients with detrusor underactivity: a short-term follow-up

作　　者：王涛[1] 张维宇[1] 胡浩[1] 王焕瑞 许克新[1] Wang Tao;Zhang Weiyu;Hu Hao;Wang Huanrui;Xu Kexin(Department of Urology,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院泌尿外科,100044

出　　处：《中华泌尿外科杂志》2020年第6期467-471,共5页Chinese Journal of Urology

摘　　要：目的探讨经尿道前列腺切除术(TURP)对逼尿肌收缩力低下(DU)患者的临床疗效。方法回顾性分析2015年1月至2019年1月北京大学人民医院72例符合手术指征且接受TURP治疗患者的临床资料。平均年龄72(51~89)岁。术前均行尿动力学检查,根据膀胱收缩力指数(BCI)和最大尿流率-逼尿肌压力(PdetQmax)将患者分为3组:DU患者[BCI<100且PdetQmax≤40 cmH2O(1 cmH2O=0.098 kPa)]共31例,分为A组(PdetQmax≤20 cmH2O)9例,B组(20 cmH2O<PdetQmax≤40 cmH2O)22例;非DU患者为C组(BCI≥100且40 cmH2O<PdetQmax≤60 cmH2O)共41例。3组患者年龄、病程差异无统计学意义(P>0.05)。3组术前国际前列腺症状评分(IPSS)分别为(26.40±5.54)、(21.04±4.61)、(18.53±4.41)分;生活质量评分(QOL)分别为(4.70±1.34)、(3.37±1.11)、(3.49±1.34)分;最大尿流率(Qmax)分别为(4.60±2.63)、(8.48±2.47)、(11.38±4.00)ml/s;残余尿量(PVR)分别为(152.90±75.26)、(90.78±51.97)、(53.23±38.98)ml。A组术前IPSS和QOL明显大于B组和C组,差异有统计学意义(P<0.05),B组和C组间差异无统计学意义(P>0.05)。A组术前Qmax明显小于B组和C组,差异有统计学意义(P<0.05);B组术前Qmax明显小于C组,差异有统计学意义(P<0.05)。A组术前PVR明显大于B组和C组,差异有统计学意义(P<0.05);B组术前PVR明显大于C组,差异有统计学意义(P<0.05)。随访3组术后的IPSS、QOL、最大自由尿流率(fQmax)和PVR,比较3组的主观指标(IPSS、QOL)和客观指标(fQmax、PVR)改善情况。结果本研究72例平均随访31.1(3~52)个月。A、B、C组术后IPSS分别为(25.50±2.84)、(16.78±4.04)与(14.98±3.41)分;QOL分别为(2.90±1.29)、(2.67±0.88)、(2.53±0.92)分;fQmax分别为(5.44±2.60)、(10.30±3.68)、(13.07±3.51)ml/s;PVR分别为(104.00±46.00)、(76.81±46.74)、(35.64±26.17)ml。与术前比较,A组QOL较术前明显改善,差异有统计学意义(P<0.05),IPSS、fQmax、PVR较术前有改善,但差异无统计学意义(P>0.05);B组和C组的IPSS、QOL、fQmax�Objective To investigate the effect of transurethral prostatectomy(TURP)on patients with detrusor underactivity(DU).Methods From January 2015 to January 2019,72 male patients from Peking University People’s hospital who underwent TURP treatment were retrospectively analyzed.The age of all patients range from 51 to 89,with an average age of 72 years old.All patients underwent urodynamic examination before surgery.The patients were divided into three groups according to BCI and PdetQmax.DU group(BCI<100 and PdetQmax≤40 cmH2O)consisted of 31 patients.Then DU patients were divided into two groups according to the PdetQmax:Group A,PdetQmax≤20 cmH2O,involving 9 patients;Group B,20 cmH2O<PdetQmax≤40 cmH2O,involving 22 patients.Non-DU group(BCI≥100 and 40 cmH2O<PdetQmax≤60 cmH2O),also named the control GroupC,included 41 patients.There was no statistically significant difference in term of age and duration of disease among the three groups(P<0.05).Preoperative international prostate symptom scores(IPSS)of the three groups were(26.40±5.54),(21.04±4.61)and(18.53±4.41),respectively.The quality of life score(QOL)were(4.70±1.34),(3.37±1.11)and(3.49±1.34),respectively.The Qmax were(4.60±2.63),(8.48±2.47)and(11.38±4.00)ml/s,respectively.The residual urine volume(PVR)were(152.90±75.26),(90.78±51.97)and(53.23±38.98)ml,respectively.The preoperative IPSS and QOL of patients in group A were significantly higher than those in group B and group C,and the difference was statistically significant(P<0.05),whereas the difference between group B and group C was not statistically significant(P>0.05).The preoperative Qmax of group A was significantly inferior than that of group B and C,with statistically significant difference(P<0.05)and group B was significantly inferior than group C,with statistically significant difference(P<0.05).The preoperative PVR of group A was significantly higher than that of group B and group C,with statistically significant difference(P<0.05)and group B was significantly higher than group

关 键 词：经尿道前列腺切除术 逼尿肌收缩力低下 尿流动力学 

分 类 号：R699[医药卫生—泌尿科学]