腹股沟无张力疝修补术联合经尿道等离子双极电切术对腹股沟疝合并良性前列腺增生患者的治疗效果  

Efficacy and safety of tension-free inguinal hernia repair combined with TUPKP for patients with inguinal hernia complicated with BPH

作　　者：裴胜利 柯超 王芳芳 阮艳玲 谢兴旺 Pei Shengli;Ke Chao;Wang Fangfang;Ruan Yanling;Xie Xingwang(Gastrointestinal Surgery,Wuhan Third Hospital,Wuhan 430060,China;Urology Surgery,Wuhan Third Hospital,Wuhan 430060,China)

机构地区：[1]武汉市第三医院胃肠外科,430060 [2]武汉市第三医院泌尿外科,430060

出　　处：《中华疝和腹壁外科杂志（电子版）》2021年第6期599-603,共5页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：武汉市医学科研项目(WX20A07)。

摘　　要：目的探讨腹股沟无张力疝修补术联合经尿道等离子双极电切术(TUPKP)对腹股沟疝合并良性前列腺增生(BPH)患者的疗效及安全性。方法回顾性分析2015年1月至2018年2月在武汉市第三医院进行治疗的86例腹股沟疝合并BPH患者相关资料,患者行同期TUPKP联合行腹腔镜经腹腹膜前疝修补术(TAPP)。评价患者的手术情况、尿动力学、前列腺症状、生活质量(QOL)及术后并发症发生情况。结果 86例患者顺利完成了手术。手术时间60~151(85.26±14.17)min,膀胱冲洗时间(27.74±3.05)min,手术出血量(174.29±19.73)ml,尿管留置时间(4.66±1.07)d,术后住院时间(6.21±1.04)d。与术前相比,术后6个月患者的国际前列腺症状评分、QOL评分、残余尿量和最大逼尿肌压均降低,最大尿流率和膀胱顺应性增加,差异有统计学意义(P均<0.05)。术后随访6个月,未发生感染、慢性疼痛、尿失禁及复发。术后发生尿潴留3例(3.49%)、血清肿11例(12.79%)。结论 TAPP联合TUPKP同期治疗腹股沟疝合并BPH安全有效,能够提高患者生活质量。Objective To explore the efficacy and safety of tension-free hernioplasty combined with transurethral plasma bipolar prostatectomy(TUPKP)in patients with inguinal hernia and benign prostatic hyperplasia(BPH).Methods The data of 86 patients with inguinal hernia and BPH treated in Wuhan Third Hospital from January 2015 to February 2018 was collected and retrospective analyzed.TUPKP combined with laparoscopic trans-abdominal preperitoneal hernia repair(TAPP)was performed at the same time.The surgical condition,urodynamics,prostate symptoms,quality of life(QOL)and complications after operation were evaluated.Results 86 patients successfully completed the operation.The average operation time was 60~151(85.26±14.17)minutes,bladder irrigation time was(27.74±3.05)minutes,bleeding volume was(174.29±19.73)ml,indwelling time of ureter was(4.66±1.07)days,and postoperative hospitalization time was(6.21±1.04)days.Compared with preoperative,the scores of international prostate symptom score(IPSS)and QOL,residual urine volume(RUV)and maximum detrusor pressure decreased,and maximum urine flow(Qmax)and bladder compliance increased,with statistical differences(P<0.05).Follow-up of 6 months after operation showed that there was no incision infection, chronic pain, urinary incontinence and recurrence. There were 3 cases postoperative urinary retention (3.49%) and 11 cases of seroma (12.79%). Conclusion TAPP combined with TUPKP in the simultaneous treatment of inguinal hernia complicated with BPH is safe and effective, and can improve the quality of life of patients.

关 键 词：良性前列腺增生 疝 腹股沟 经尿道等离子双极电切术 疝修补术 并发症 

分 类 号：R656.21[医药卫生—外科学] R699.8[医药卫生—临床医学]