不同术式对BPH所致梗阻性膀胱顺应性下降患者血清PGE 2、5-HT、尿动力学指标及并发症的影响  

Influence of different surgical methods on serum PGE 2,5-HT,urodynamic indexes and complications in patients with obstructive bladder compliance decline caused by BPH

作　　者：沈都 李佳乐 康绍叁 SHEN Du;LI Jia-le;KANG Shao-san(Clinical Medical College,North China University of Technology,Tangshan Hebei 063000,China;Department of Urology,North China University of Technology Affiliated Hospital,Tangshan Hebei 063000,China)

机构地区：[1]华北理工大学临床医学院,河北唐山063000 [2]华北理工大学附属医院泌尿外科,河北唐山063000

出　　处：《临床和实验医学杂志》2024年第19期2061-2065,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究课题计划项目(编号:20221358)。

摘　　要：目的探讨应用不同术式治疗良性前列腺增生(BPH)所致梗阻性膀胱顺应性(BC)下降患者的临床效果。方法回顾性选取2022年2月至2024年2月华北理工大学附属医院接受诊治的130例BPH所致梗阻性BC下降患者作为研究对象。根据手术方案不同将患者分为对照组(n=68)和研究组(n=62)。对照组采取经尿道前列腺电切术(TURP)治疗,研究组采取经尿道双极等离子电切术(BPRP)治疗。比较两组围术期相关指标(手术时间、术中出血量以及住院时间)、术前及术后2 d的血清因子指标[前列腺素E 2(PGE 2)、5-羟色胺(5-HT)]、术前及术后3个月的尿动力学指标[最大尿流率(Qmax)、BC、残余尿量(PVR)]、并发症发生情况以及术前、术后3个月的生活质量[良性前列腺增生患者专用生活质量量表(BPHQLS)]评分。结果研究组的手术时间、住院时间分别为(45.16±7.37)min、(5.26±1.04)d,均短于对照组[(52.47±8.36)min、(7.43±1.47)d],术中出血量为(63.39±12.65)mL,少于对照组[(86.73±21.47)mL],差异均有统计学意义(P<0.05)。研究组术后2 d的PGE 2、5-HT水平分别为(17.48±4.52)ng/L、(539.68±48.48)ng/mL,均低于对照组[(25.73±5.27)ng/L、(625.87±52.62)ng/mL],差异均有统计学意义(P<0.05)。研究组术后3个月的BC、Qmax分别为(28.07±4.72)mL/cmH 2O、(18.53±3.86)mL/s,均高于对照组[(24.86±4.35)mL/cmH 2O、(13.79±2.41)mL/s],PVR为(38.38±6.96)mL,低于对照组[(49.27±8.64)mL],差异均有统计学意义(P<0.05)。研究组并发症发生率为4.84%,低于对照组(20.59%),差异有统计学意义(P<0.05)。术后3个月的疾病、心理、满意度BPHQLS评分分别为(117.64±12.54)、(43.21±4.22)、(34.36±5.77)分,均高于对照组[(94.61±13.64)、(37.46±6.43)、(28.64±5.74)分],差异均有统计学意义(P<0.05)。结论BPRP治疗BPH所致梗阻性BC下降患者,创伤更小,可降低PGE 2、5-HT水平,疼痛更轻,可有效改善尿动力学指标,还可降低术后并发症发生率,提升患�Objective To investigate the clinical effect of different surgical methods on patients with obstructive bladder compliance(BC)decline caused by benign prostatic hyperplasia(BPH).Methods Patients with obstructive BC decline caused by BPH who were treated in North China University of Technology Affiliated Hospital from February 2022 to February 2024 were retrospectively selected as the research objects.According to different surgical procedures,130 patients were divided into the control group(n=68)and the study group(n=62).The control group received transurethral resection of the prostate(TURP),and the study group received bipolar plasmakinetic resection of the prostate(BPRP).The perioperative related indexes(operation time,intraoperative blood loss and hospital stay),serum factor indexes[prostaglandin E 2(PGE 2),5-hydroxytryptamine(5-HT)]before surgery and 2 days after operation,urodynamic indexes[maximum urinary flow rate(Qmax),BC,post-void residual urine volume(PVR)]before surgery and 3 months after operation,complications and quality of life[benign prostatic hyperplasia quality of life scale(BPHQLS)]before surgery and 3 months after operation were compared between both groups.Results The operation time and hospitalization time of the study group were(45.16±7.37)min and(5.26±1.04)d,respectively,which were shorter than those of the control group[(52.47±8.36)min,(7.43±1.47)d],and the intraoperative blood loss was(63.39±12.65)mL,which was less than that of the control group[(86.73±21.47)mL],the differences were statistically significant(P<0.05).The levels of PGE 2 and 5-HT in the study group at 2 days after operation were(17.48±4.52)ng/L and(539.68±48.48)ng/mL,respectively,which were lower than those in the control group[(25.73±5.27)ng/L,(625.87±52.62)ng/mL],the differences were statistically significant(P<0.05).The BC and Qmax of the study group at 3 months after operation were(28.07±4.72)mL/cmH 2O and(18.53±3.86)mL/s,respectively,which were higher than those of the control group[(24.86±4.35)mL/cmH 2O

关 键 词：良性前列腺增生 梗阻性膀胱顺应性下降 经尿道双极等离子电切术 经尿道前列腺电切术 

分 类 号：R699.8[医药卫生—泌尿科学]