不同术式尿道扩张治疗经尿道前列腺电切除术后前尿道狭窄的效果  

Effect of Different Surgical Methods of Urethral Dilatation on Treatment of Anterior Urethral Stricture After Transurethral Resection of the Prostate

作　　者：颜兵 赵娜 康元朝 YAN Bing;ZHAO Na;KANG Yuanchao(Deparment of Urology,Dandong Hospital of Traditional Chinese Medicine in Liaoning Province,Dandong 118000,China)

机构地区：[1]辽宁省丹东市中医院泌尿外科,丹东118000

出　　处：《宁夏医科大学学报》2021年第10期1079-1083,共5页Journal of Ningxia Medical University

摘　　要：目的探讨不同术式尿道扩张治疗经尿道前列腺电切除(TURP)术后前尿道狭窄的效果,分析对患者尿流动力学、自主排尿功能、生活质量的影响。方法选取2016年1月至2019年6月在辽宁省丹东市中医院诊治的TURP术后前尿道狭窄患者60例作为研究对象,按照治疗方法将患者分为研究组(S形丝状尿道探子+硬质尿道探子扩张术)29例和对照组(经尿道Otis刀尿道狭窄内切开+硬质尿道探子扩张术)31例。采用生活质量综合评定问卷(GQOLI-74)评估患者术前、术后3个月的生活质量,比较两组围术期相关临床指标、尿流动力学、自主排尿功能及生活质量。结果研究组患者的手术时间、住院时间均短于对照组(P均<0.05);研究组与对照组患者的治愈率、尿失禁、尿潴留发生率、排尿成功率差异均无统计学意义(P均>0.05);研究组患者的自主排尿率(93.10%)高于对照组(58.06%),排尿困难率(6.90%)低于对照组(32.26%)(P均<0.05)。术后两组患者最大尿流率(Qmax)均升高,且研究组高于对照组(P均<0.05);术后两组膀胱残余尿量(PVR)均降低,且研究组低于对照组(P均<0.05)。术后3个月两组患者物质生活状态、躯体功能、社会功能、心理功能评分均高于术前,且研究组高于对照组(P均<0.05)。结论两种术式均可治疗TURP术后前尿道狭窄,但S形丝状尿道探子+硬质尿道探子扩张术患者治疗时间、住院时间较少,且无尿失禁、尿潴留的风险,可有效改善患者尿流动力学、生活质量,恢复自主排尿功能。Objective To explore the effects of different operative urethral dilations on the treatment of anterior urethral stricture after transurethral resection of the prostate(TURP)on the patient’s urodynamics,voluntary urinary function and quality of life.Methods From January 2016 to June 2019,60 patients with anterior urethral stricture after TURP diagnosis and treatment were selected as the research object,and the patients were divided into study group according to different treatment methods(S-shaped filamentous urethral probe+hard Mass urethral probe dilation)with 29 cases and control group(transurethral Otis knife urethral stenosis incision+rigid urethral probe dilation)with 31 cases.A comprehensive quality of life questionnaire(GQOLI-74)was used to assess the quality of life before and 3 months after surgery,and the perioperative related clinical indicators,urodynamics,voluntary micturition function,and quality of life were compared between the two groups.Results The operation time and hospital stay of the study group were shorter than those of the control group(P all<0.05);the cure rate,urinary incontinence,urinary retention rate,and urination success rate of the study group were not statistically significant compared with those of the control group(P all>0.05).The rate of spontaneous urination in the study group(93.10%)was higher than that in the control group(58.06%),and the rate of dysuria in the study group(6.90%)was lower than that of the control group(32.26%)(P all<0.05).The maximum urinary flow rate(Qmax)of the two groups increased after operation,and the study group was higher than the control group(P all<0.05);the residual urine volume(PVR)of the bladder in the two groups after operation decreased,and the study group was lower than the control group(P all<0.05).The scores of physical function,social function,and psychological function of the two groups of material life after 3 months after surgery were higher than those before operation,and the study group was higher than the control group(P all<0.05)

关 键 词：S形丝状尿道探子 Otis刀 尿道狭窄 尿道扩张 尿流动力学 

分 类 号：R699.6[医药卫生—泌尿科学]