经尿道前列腺电切剜除术对前列腺术后尿失禁及机体应激反应的影响  

Effect of Transurethral Resection of the Prostateon Urinary Incontinence and Stress Response After Prostate Surgery

作　　者：彭雄兵 钟英亮 金海涛 PENG Xiongbing;ZHONG Yingliang;JIN Haitao(Department of Urology,Ningdu County People's Hospital,Ningdu 342800,Jiangxi,China)

机构地区：[1]宁都县人民医院泌尿外科,江西宁都342800

出　　处：《医学信息》2024年第21期99-102,共4页Journal of Medical Information

基　　金：赣州市指导性科技计划项目(编号:GZ2023ZSF544)。

摘　　要：目的研究经尿道前列腺电切术(TURP)与经尿道前列腺剜除术(TUEP)对前列腺术后尿失禁及机体应激反应的影响。方法以2022年1月-2023年9月宁都县人民医院泌尿外科收治的60例良性前列腺增生(BPH)患者为研究对象,经随机数字表法分为TURP组与TUEP组,各30例。TURP行经尿道前列腺电切术治疗,TUEP组应用经尿道前列腺剜除术治疗,比较两组手术相关指标(术中出血量、手术时间、腺体切除质量、术后冲洗液转清时间)、血红蛋白(Hb)及血钠指标、尿失禁发生率、机体应激反应[肾上腺素(A)、去甲肾上腺素(NE)、肾素(PRA)、血管紧张素Ⅱ(AngⅡ)]、术后并发症情况。结果TUEP组术中出血量、手术时间、术后冲洗液转清时间少于TURP组,腺体切除质量大于TURP组(P<0.05);两组术后Hb、血钠水平均有下降,但TUEP组术后Hb、血钠水平高于TURP组(P<0.05)。TUEP组术后尿失禁发生率(3.33%)低于TURP组(20.00%)(P<0.05)。TUEP组术中及术后6 h机体应激反应指标(A、NE、PRA、AngⅡ)均低于TURP组(P<0.05)。TUEP组术后并发症发生率(10.00%)低于TURP组(30.00%)(P<0.05)。结论TUEP可降低前列腺术后尿失禁及并发症的发生风险,且术中出血少、手术时间短、腺体切除彻底,可减轻术中及术后机体应激反应,减少Hb及血钠流失,相较于TURP具有更高的临床优势。Objective To study the effects of transurethral resection of the prostate(TURP)and transurethral enucleation of the prostate(TUEP)on urinary incontinence and stress response after prostate surgery.Methods Sixty patients with benign prostatic hyperplasia(BPH)admitted to the Department of Urology of Ningdu County People's Hospital from January 2022 to September 2023 were enrolled in the study.They were divided into TURP group and TUEP group by random number table method,with 30 patients in each group.TURP was treated with transurethral resection of the prostate,and TUEP group was treated with transurethral enucleation of the prostate.The operation-related indicators(intraoperative blood loss,operation time,gland resection quality,postoperative flushing fluid clearance time),hemoglobin(Hb)and blood sodium index,incidence of urinary incontinence,body stress response[epinephrine(A),norepinephrine(NE),renin(PRA),angiotensin Ⅱ(AngⅡ)],and postoperative complications were compared between the two groups.Results The intraoperative blood loss,operation time and postoperative irrigation fluid clearance time in the TUEP group were less than those in the TURP group,and the weight of gland resection was greater than that in the TURP group(P<0.05).The levels of Hb and serum sodium in the two groups decreased after operation,but the levels of Hb and serum sodium in the TUEP group were higher than those in the TURP group(P<0.05).The incidence of postoperative urinary incontinence in TUEP group(3.33%)was lower than that in TURP group(20.00%)(P<0.05).The stress response indexes(A,NE,PRA,AngⅡ)of TUEP group were lower than those of TURP group during operation and 6 h after operation(P<0.05).The incidence of postoperative complications in TUEP group(10.00%)was lower than that in TURP group(30.00%)(P<0.05).Conclusion TUEP can reduce the risk of urinary incontinence and complications after prostate surgery,with less intraoperative bleeding,shorter operation time,and complete gland resection.Meanwhile,it can reduce intraoperative an

关 键 词：经尿道前列腺电切术 经尿道前列腺剜除术 术后尿失禁 机体应激反应 术中出血量 

分 类 号：R699[医药卫生—泌尿科学]