经尿道柱状水囊前列腺扩开术加电切术治疗前列腺增生在高危患者中的应用  

Application of TUCBDP combined with TURP in the treatment of high-risk BPH patients

作　　者：吴耀宝 孙文明 秦树叶 常艳华[2] 魏义[3] 杨元锋 邢瑞 李冰 WU Yao-bao;SUN Wen-ming;QIN Shu-ye;CHANG Yan-hua;WEI Yi;YANG Yuan-feng;XING Rui;LI Bing(Department of Urology,Wulian People's Hospital of Shandong Province,Wulian 262300;Binzhou People's Hospital of Shandong Province,Binzhou 256600;Boxing People's Hospital of Shandong Province,Boxing 256500;Zouping Central Hospital of Shandong Province,Zouping 256200;Linyi People's Hospital of Shandong Province,Linyi 251500,China)

机构地区：[1]山东省五莲县人民医院泌尿外科,山东五莲262300 [2]山东省滨州市人民医院,山东滨州256600 [3]山东省博兴县人民医院,山东博兴256500 [4]山东省邹平市中心医院,山东邹平256200 [5]山东省临邑人民医院,山东临邑251500

出　　处：《现代泌尿外科杂志》2020年第8期720-723,共4页Journal of Modern Urology

摘　　要：目的探讨经尿道柱状水囊前列腺扩开术(TUCBDP)联合前列腺电切术(TURP)治疗前列腺增生(BPH)合并其他疾病高危患者的安全性和疗效。方法回顾性分析山东省五莲县人民医院泌尿外科、山东省滨州市人民医院、山东省博兴县人民医院、山东省邹平市中心医院、山东省临邑人民医院5家医院2016年11月至2019年5月采用TUCBDP+TURP联合治疗前列腺增生(BPH)患者218例作为联合组、另外选取200例采用TURP手术治疗的BPH患者作为对照组,统计分析两组患者的手术时间、手术出血量、导尿管留置时间、住院时间、手术前后患者的残余尿量、最大尿流率、国际前列腺症状量表(IPSS)评分及相关并发症的发生率。结果联合组与对照组比较手术时间[(27.0±7.1)min vs.(58.6±11.0)min]、手术出血量[(59.6±14.6)mL vs.(73.6±16.3)mL]均低于对照组(P<0.05);术后3个月联合组残余尿量[(32.8±8.0)mL vs.(36.0±8.5)mL]、最大尿流率[(18.3±3.1)mL/s vs.(17.9±3.4)mL/s]、IPSS评分(8.4±0.9 vs.8.8±1.0)均低于对照组(P<0.05);术后6个月联合组残余尿量[(26.4±7.5)mL vs.(30.0±7.9)mL]、最大尿流率[(20.3±3.4)mL/s vs.(19.6±3.8)mL/s]、IPSS评分(7.1±0.4 vs.7.3±0.5)均低于对照组(P<0.05);两组患者术后导尿管留置时间、住院时间、手术并发症发生率差异均无统计学意义(P>0.05)。结论TUCBDP联合TURP治疗BPH高危患者具有降低手术难度、减少术中出血量、更好的改善前列腺相关临床症状的特点,值得在BPH高危人群中应用。Objective To investigate the safety and efficacy of transurethral columnar hydrosacral prostate expansion(TUCBDP)combined with transurethral resection of the prostate(TURP)in the treatment of high-risk benign prostatic hyperplasia(BPH)patients.Methods A retrospective analysis was conducted in the urology departments of 5 hospitals with which the authors worked.A total of 218 BPH cases treated with TUCBDP plus TURP during Nov.2016 and May 2019 were selected as the combined group,and another 200 BPH patients treated with TURP during the same period served as the control group.The operation time,intraoperative blood loss,catheter indwelling time,hospitalization time,residual urine volume,maximum flow rate,International Prostate Symptom Scale(IPSS)score and incidence of complications in both groups were analyzed.Results Compared with the control group,the combined group had shorter operation time[(27.0±7.1)min vs.(58.6±11.0)min,P<0.05],less intraoperative blood loss[(59.6±14.6)mL vs.(73.6±16.3)mL,P<0.05];less residual urine volume[(32.8±8.0)mL vs.(36.0±8.5)mL,P<0.05],lower maximum flow rate[(18.3±3.1)mL/s vs.(17.9±3.4)mL/s,P<0.05],lower IPSS score(8.4±0.9 vs.8.8±1.0,P<0.05)3 months after operation;less residual urine volume[(26.4±7.5)mL vs.(30.0±7.9)mL,P<0.05],lower maximum flow rate[(20.3±3.4)mL/s vs.(19.6±3.8)mL/s,P<0.05],lower IPSS score(7.1±0.4 vs.7.3±0.5,P<0.05)6 months after operation.There were no significant differences between the two groups in catheter indwelling time,hospitalization time and incidence of complications(P>0.05).Conclusion TUCBDP combined with TURP can reduce the surgical difficulties,reduce the amount of intraoperative bleeding,and improve the clinical symptoms.It is worth applying in the high-risk BPH patients.

关 键 词：经尿道柱状水囊前列腺扩开术 前列腺电切术 前列腺增生 

分 类 号：R699[医药卫生—泌尿科学]