新型螺旋形热膨胀前列腺支架治疗良性前列腺增生的疗效观察  

Observation of the clinical efficacy of a new type of spiral thermo-expandable prostate stent in the treatment of benign prostatic hyperplasia

作　　者：顾杰[1] 李杜渐 李权 朱彦松 GU Jie;LI Dujian;LI Quan(Department of Urology,Shanghai Fourth People's Hospital affiliated to Tongji University,Shanghai 200434,China)

机构地区：[1]同济大学附属上海市第四人民医院泌尿外科,200434

出　　处：《临床外科杂志》2023年第2期138-141,共4页Journal of Clinical Surgery

基　　金：上海市虹口区卫生和计划生育委员会科研课题资助计划(虹卫2003-07)。

摘　　要：目的评估新型螺旋形热膨胀前列腺支架(Memokath 028,Pnn Medical)治疗具有中重度下尿路症状的良性前列腺增生病人的临床疗效及安全性。方法2020年10月~2021年6月我院收治有中重度的下尿路症状的前列腺增生病人50例,均接受经尿道前列腺支架置入手术。采集病人术前及术后1、3、6和12个月的尿动力参数包括国际前列腺症状评分(International Prostate Symptom Score,IPSS)、生活质量评分(Quality of Life,QOL)、最大尿流率(maximum urinary flow rate,Qmax)、残余尿参数值,同时记录围手术期及术后并发症等指标。结果平均手术时间19.8分钟,术后10分钟VAS平均评分为(1.8±0.6)分。术后即恢复自主排尿,所有病人术后第1天出院。术后血尿7例(14%),尿急6例(12%),排尿疼痛4例(8%)。5例(10%)病人发生急性尿路感染(UTI)。术后1个月平均IPSS、QOL评分、Qmax、PVR分别为(13.9±3.2)分、(2.4±0.5)分、(11.9±1.6)ml/s和(52.7±22.5)ml,与手术前比较差异有统计学意义(P<0.05),随着时间的延长,上述指标保持稳定。结论新型螺旋形热膨胀前列腺支架治疗前列腺部位的尿路梗阻操作简便、安全、可行。短期疗效确切,早期并发症少。Objective To evaluate the clinical efficacy and safety of a new spiral thermo-expandable prostate stent(Memokath 028,Pnn Medical)in the treatment of patients with benign prostatic hyperplasia with moderate to severe lower urinary tract symptoms.Methods Retrospective analysis was peformed on 50 patients with benign prostatic hyperplasia who underwent implantation of prostatic stent from October 2020 to June 2021 in the Shanghai Fourth People’s Hospital of Tongji University.The urodynamic parameters of patients before operation and 1,3,6 and 12 months after operation were collected,including International Prostate Symptom Score(IPSS),Quality of Life(QOL),and maximum urinary flow rate(Qmax),residual urine parameter values,and records such as perioperative and postoperative complications.Results The average operation time was 19.8 minutes,and the average VAS score at 10 minutes after surgery was 1.8±0.6 points.Spontaneous urination was restored after the operation,and all patients were discharged on the first day after the operation.In terms of postoperative complications,there were 7(14%)cases of postoperative hematuria,6(12%)cases of urination urgency,and 4(8%)cases of painful urination.Acute urinary tract infection(UTI)occurred in 5 patients(10%).The first follow-up was conducted at 1 months after the operation.The average IPSS,QOL score and PVR were 13.9±3.2 points,2.4±0.5 points,and(52.7±22.5)ml,respectively,which were significantly lower than those before the operation(P<0.05).Qmax was(11.9±1.6)ml/s,which was significantly higher than that before surgery(P<0.05).As time went on,the above indicators remain stable.Conclusion The new spiral thermo-expandable prostate stent is easy to operate.It is safe and feasible for the treatment of urinary tract obstruction in the prostate.The short-term clinical efficacy is definite,and the early complications are few.

关 键 词：前列腺支架 前列腺增生 下尿路症状 

分 类 号：R699.8[医药卫生—泌尿科学]