保留前叶的经尿道前列腺等离子剜除术对BPH患者的疗效及术后尿失禁发生率的影响  

Effect of plasmakinetic enucleation of the prostate with preservation of anterior lobe on the treatment and influence on the incidence of postoperative urinary incontinence in patients with BPH

作　　者：念宽余 张丹 王永锋 郭军 NIAN Kuanyu;ZHANG Dan;WANG Yongfeng;GUO Jun(Department of General Surgery,Shaanxi Rehabilitation Hospital,Xi'an,Shaanxi 710000,China)

机构地区：[1]陕西省康复医院普外科,陕西西安710000

出　　处：《检验医学与临床》2024年第5期658-661,666,共5页Laboratory Medicine and Clinic

摘　　要：目的 分析保留前叶的经尿道前列腺等离子剜除术(PKEP)对前列腺增生症(BPH)患者的疗效及术后尿失禁发生率的影响。方法 选取2020年11月至2022年11月该院收治的80例BPH患者按照不同手术治疗方式分为试验组(43例)及对照组(37例)。对照组给予经尿道双极等离子前列腺电切术(PKRP)治疗,试验组给予保留前叶的PKEP治疗,对比两组患者手术时间、术中出血量、留置导管时间、住院时间、术后尿失禁发生率,以及术前及术后国际前列腺症状评分(IPSS)、残余尿量(RUV)、最大尿流率(Qmax)、血清睾酮(T)、前列腺特异性抗原(PSA)、前列腺素E_(2)(PGE_(2))水平及健康状态调查表(GQOL-74)评分。结果 试验组术中出血量少于对照组,手术时间、留置导管时间、住院时间短于对照组,差异均有统计学意义(P<0.05)。术后两组IPSS、RUV、T、PGE_(2)、PSA水平低于术前,且试验组低于对照组,差异均有统计学意义(P<0.05)。术后两组心理功能、社会功能、躯体功能、物质生活维度的GQOL-74评分及Qmax高于术前,且试验组高于对照组,差异均有统计学意义(P<0.05)。试验组术后1周尿失禁的总发生率低于对照组(P<0.05)。结论 与PKRP治疗相比,采用PKEP治疗BPH患者的术中出血量更少,手术创伤更小,术后恢复情况更优,以及更能改善尿流动力学,降低术后尿失禁发生率,提高患者生活质量。Objective To analyze the effect of plasmakinetic enucleation of the prostate(PKEP) with preservation of the anterior lobe in the treatment of patients with benign prostatic hyperplasia(BPH) and their influence on the incidence of postoperative urinary incontinence.Methods A total of 80 patients with BPH admitted to this hospital from November 2020 to November 2022 were selected and divided into an experimental group(43 cases) and a control group(37 cases) according to different surgical treatment methods.The control group received transurethral bipolar plasma prostatectomy(PKRP),while the experimental group received PKEP with preservation of anterior lobe.The operation time,intraoperative blood loss,catheter indwelling time,hospitalization time,and incidence of postoperative urinary incontinence,preoperative and postoperative International Prostate Symptom Score(IPSS),residual urine volume(RUV),maximum urinary flow rate(Qmax),serum testosterone(T),prostate specific antigen(PSA),prostaglandin E_(2)(PGE_(2)) levels and Health Status Questionnaire(GQOL-74) score were compared between the two groups.Results The intraoperative blood loss was less than those of the control group,operation time,catheter indwelling time and hospitalization time of the experimental group were shorted than those of the control group,and the differences were statistically significant(P<0.05).The levels of IPSS,RUV,T,PGE_(2) and PSA in the two groups after operation were lower than those before operation,and the experimental group were lower than the control group,the differences were statistically significant(P<0.05).The GQOL-74 scores of psychological function,social function,physical function and material life dimensions and Qmax of the two groups after operation were higher than those before operation,and the experimental group were higher than the control group,the differences were statistically significant(P<0.05).The total incidence of urinary incontinence in the experimental group was lower than that in the control group at 1 week af

关 键 词：保留前叶的经尿道前列腺等离子剜除术 前列腺增生症 尿失禁 治疗 发生率 

分 类 号：R699.8[医药卫生—泌尿科学]