改良全盆底重建技术在腹腔镜前列腺癌根治术后早期尿控中的应用效果  

Application effect of modified total pelvic floor reconstruction in early urinary continence after laparoscopic radical prostatectomy

作　　者：万滨[1] 张文圣[1] 邓新喜[1] 陶韬 WAN Bin;ZHANG Wensheng;DENG Xinxi;TAO Tao(Department of Urology,Jiujiang NO.1 People's Hospital,Jiangxi Province,Jiujiang 332000,China)

机构地区：[1]江西省九江市第一人民医院泌尿外科,江西九江332000

出　　处：《中国当代医药》2022年第35期19-22,27,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202211854)。

摘　　要：目的探讨改良全盆底重建在腹腔镜前列腺癌根治术后早期尿控中的应用效果。方法选取2020年1月至2021年12月在九江市第一人民医院泌尿外科住院治疗的80例前列腺癌患者作为研究对象,采用随机数字表法将其分为对照组和观察组,每组40例。对照组采用腹腔镜前列腺癌根治术并行常规全盆底筋膜重建术,观察组采用腹腔镜前列腺癌根治术并应用改良常规全盆底重建术。比较两组患者的手术时间、盆底重建时间、术中出血量、术后康复时间、术后早期控尿情况、尿失禁以及术后其他并发症发生率。结果两组患者的手术时间、盆底重建时间、术中出血量及术后康复时间比较,差异无统计学意义(P>0.05)。两组患者拔管后不同时间的尿控率比较,差异有统计学意义(P<0.05)。拔管后即刻,拔管后1、2周,两组患者的尿控率比较,差异无统计学意义(P>0.05)。拔管后1个月、术后3个月,观察组的尿控率高于对照组,差异有统计学意义(P<0.05)。观察组术后3个月尿失禁发生率低于对照组,差异有统计学意义(P<0.05)。两组患者在其他手术切缘阳性率、术后3个月保留勃起成功率、直肠损伤率、术后出血率的数据比较,差异均无统计学意义(P>0.05)。结论腹腔镜前列腺根治性切除术中应用改良全盆底重建技术,利于患者术后早期尿控功能恢复,改善了患者的生活质量,具有较好的安全性和临床效果,值得在临床中推广运用。Objective To investigate the application effect of modified total pelvic floor reconstruction in early urinary control after laparoscopic radical prostatectomy.Methods A total of 80 patients with prostate cancer hospitalized in the Department of Urology,Jiujiang NO.1 People's Hospital from January 2020 to December 2021 were selected as the research objects,they were divided into the control group and the observation group according to random number table method,with 40 cases in each group.Patients in the control group were treated with laparoscopic radical prostatectomy and conventional total pelvic floor fascia reconstruction,while patients in the observation group were treated with laparoscopic radical prostatectomy and modified conventional total pelvic floor reconstruction.The operation time,pelvic floor reconstruction time,intraoperative blood loss,postoperative recovery time,early postoperative urinary control,urinary incontinence and incidence of other postoperative complications were compared between the two groups.Results There were no significant differences in operation time,pelvic floor reconstruction time,intraoperative blood loss and postoperative recovery time between the two groups(P>0.05).There were statistically significant differences in the urinary control ratio at different times after extubation between the two groups(P<0.05).Immediately after extubation,1 week and 2 weeks after extubation,there was no significant difference in the ratio of urine control between the two groups(P>0.05).One month after extubation and 3 months after operation,the urinary control rate in the observation group was higher than that in the control group(P<0.05).The incidence of urinary incontinence 3 months after operation in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the positive rate of other surgical margins,the success rate of erectile retention 3 months after operation,the rate of rectal injury

关 键 词：腹腔镜 前列腺癌根治术 全盆底重建 早期尿控 

分 类 号：R737.25[医药卫生—肿瘤]