应用多学科联合诊疗对高风险前列腺增生患者手术治疗率及生活质量的影响  

Effects of muti-disciplinary treatment on surgical rate and quality of life in patients with highrisk benign prostatic hyperplasia

作　　者：刘洪久[1] 郭磊 陈延[1] 孙超[1] 肖永强[1] Liu Hongjiu;Guo Lei;Chen Yan;Sun Chao;Xiao Yongqiang(Department of Urology,the First Hospital of Shijiazhuang City,Shijiazhuang 050011,China)

机构地区：[1]石家庄市第一医院泌尿外科,050011

出　　处：《国际泌尿系统杂志》2021年第6期997-1001,共5页International Journal of Urology and Nephrology

基　　金：石家庄市卫生和计划生育委员会资助项目(171462133)。

摘　　要：目的观察多学科协作诊疗(MDT)对高龄良性前列腺增生(BPH)患者的手术治疗率、无管生存率和生活质量的影响。方法回顾性选取2016年11月至2017年11月应用MDT前的72例高龄BPH患者设为对照组(常规诊疗),选取2017年12月至2018年12月应用MDT后的68例高龄BPH患者设为观察组(MDT诊疗)。记录两组患者经尿道手术治疗率、手术时间、术中出血量、治疗后尿失禁发生率、治疗后1年的总生存率和无管生存率等;分别于治疗前和治疗后3个月,检测两组患者的最大尿流率(Q_(max))和残余尿量(PVR);采用国际前列腺症状(IPSS)评分评估两组患者的症状严重程度;采用生活质量(QOL)评分评估两组患者的生活质量;采用国际勃起功能指数-5(IIEF-5)评估两组患者的性功能。结果观察组患者的经尿道手术治疗率明显高于对照组(P<0.05);治疗后,观察组患者的Q_(max)和IIEF-5评分明显高于对照组(P<0.05),PVR、IPSS和QOL评分明显低于对照组(P<0.05);观察组患者的1年生存率为91.18%(62/68),与对照组的88.89%(64/72)比较,差异无统计学意义(P>0.05),观察组的无管生存率为38.24%(26/68),明显高于对照组的20.83%(15/72),差异有统计学意义(P<0.05)。结论MDT诊疗模式可以提高高龄BPH患者的经尿道手术治疗率和无管生存率,改善患者的生活质量。Objective To observe effects of muti-disciplinaiy treatment(MDT)on tubless survival rate and quality of life in elderly patients with benign prostatic hyperplasia(BPH).Methods A retrospective analysis was performed on elderly patients with BPH from November 2016 to November 2017 before application of MDT mode(control group,72 cases)and elderly patients with BPH from December 2017 to December 2018 after application of the MDT mode(observation group,68 cases).The control group was given routine treatment,while observation group was given MDT mode.The rates of transurethral surgery,operative time,intraoperative blood loss,incidence of urinary incontinence after treatment,total survival rate and tubeless survival rate after 1 year of treatment in both groups were recorded.Before treatment and after 3 months of treatment,maximum flow rate(Q_(max))and postvoid residual volume(PVR)in both groups were detected.International prostate symptom score(IPSS)was applied to assess symptoms severity in both groups.Quality of life index(QOL)was applied to assess quality of life in both groups.International erectile function index-5(IIEF-5)was applied to assess sexual function in both groups.Results The rate of transurethral surgery in observation group was significantly higher than in control group(47.06%vs.29.17%)(P<0.05).After treatment,Q_(max)<and IIEF-5 scores in observation group were significantly higher than those in control group(P<0.05),while PVR,IPSS and QOL scores were significantly lower than those in control group(P<0.05).The 1-year survival rate of patients in the observation group was no difference with control group(91.18%vs.88.89%)(P>0.05),and tubeless survival rate was significantly higher than that of control group(38.24%vs.20.83%)(P<0.05).Conclusions MDT mode can improve transurethral surgical treatment rate and tubeless survival rate in elderly patients with BPH,improve quality of life.

关 键 词：前列腺增生 高龄 多学科诊疗模式 外科手术 

分 类 号：R699.8[医药卫生—泌尿科学]