1.94μm铥激光治疗高龄良性前列腺增生对储尿期症状及尿动力学参数的影响  

Effect of 1.94μm thulium laser resection on symptoms during urine storage and urodynamic parameters in the elderly with benign prostatic hyperplasia

作　　者：舒辉[1] 周帅 Shu Hui;Zhou Shuai(Department of Urology,Xiaogan Central Hospital,Xiaogan 432000,China;Department of Urology,Zhongshan Hospital of Wuhan University,Wuhan 430000,China)

机构地区：[1]孝感市中心医院泌尿外科,孝感432000 [2]武汉大学中山医院泌尿外科,武汉430000

出　　处：《国际泌尿系统杂志》2023年第3期448-452,共5页International Journal of Urology and Nephrology

摘　　要：目的研究1.94μm铥激光切除术治疗高龄良性前列腺增生对储尿期症状及尿动力学参数的影响。方法选取2019年6月至2020年7月于孝感市中心医院收治的82例良性前列腺增生患者,随机分为对照组(行经尿道前列腺电切术)与观察组(行1.94μm铥激光切除术),每组各41例。比较两组患者的手术时间、留置尿管时间以及住院时间、储尿期症状评分[国际前列腺症状评分(IPSS)、膀胱过度活动症症状评分(OABSS),生活质量(QOL)评分]、尿动力学参数[最大尿流率(Q_(max))、最大逼尿肌压力(Pdet_(max))、最大尿道闭合压(MUCP)]。记录两组患者术后1个月的并发症发生情况,分析良性前列腺增生患者临床病理特征及预后的关系。结果观察组的手术时间短于对照组(P<0.05);术后1个月两组患者的IPSS评分、OABSS评分、QOL评分均较术前下降,其中观察组下降程度更明显,差异均有统计学意义(均P<0.05);术后1个月两组患者的Q_(max)、Pdet_(max)均升高,MUCP均下降,其中观察组变化程度更明显,差异均有统计学意义(均P<0.001);观察组的并发症发生率低于对照组[12.20%(5/41)vs.31.71%(13/41),P<0.05];良性前列腺增生患者的预后良好与年龄、逼尿肌压力、手术方式具有相关性(均P<0.05);逼尿肌压力是影响良性前列腺增生患者1个月预后进展的独立因素,差异有统计学意义(OR=1.473,95%CI:1.009~2.150,P=0.046)。结论1.94μm铥激光切除术治疗高龄良性前列腺增生,能较好地缩短手术时间,缓解储尿期症状,改善尿动力学参数,安全性高,临床应重视逼尿肌压力较差的高龄患者,以期改善患者预后。Objective To study the effects of 1.94μm thulium laser resection on symptoms during urine storage and urodynamic parameters in the elderly with benign prostatic hyperplasia.Methods From June 2019 to July 2020,82 patients with benign prostatic hyperplasia admitted to Xiaogan Central Hospital were randomly divided into control group(transurethral resection of prostate)and observation group(1.94μm thulium laser resection),41 cases in each group.The operation time,catheter indwelling time,hospital stay,urinary storage symptom score[international prostate symptom score(IPSS),overactive bladder symptom score(OABSS)and quality of life(QOL)score]were compared between the two groups.Urodynamic parameters[_(max)imum urine flow rate(Q_(max)),_(max)imum detrusor pressure(Pdet_(max)),_(max)imum urethral closure pressure(MUCP)].The incidence of complications 1 month after surgery was recorded in the two groups,and the relationship between clinicopathological features and prognosis of patients with benign prostatic hyperplasia was analyzed.Results The operation time of the observation group was shorter than that of the control group(P<0.05).One month after operation,the IPSS score,OABSS score and QOL score of the patients in the two groups were decreased,and the degree of decline in the observation group was more obvious,the difference was statistically significant(all P<0.05).One month after operation,Q_(max) and Pdet_(max) of patients in the two groups increased,and MUCP decreased.The degree of change in the observation group was more obvious,and the difference was statistically significant(all P<0.001).The incidence of complications in the observation group was lower than that in the control group[12.20%(5/41)vs.31.71%(13/41),P<0.05].The good prognosis of patients with benign prostatic hyperplasia was correlated with age,detrusor pressure and surgical method(all P<0.05).The detrusor pressure is an independent factor that affects the 1-month prognosis of patients with BPH,and the difference is statistically significant(OR=1

关 键 词：前列腺增生 激光疗法 储尿症状 尿动力学 

分 类 号：R697.3[医药卫生—泌尿科学]