输尿管置管联合钬激光碎石治疗输尿管结石合并前列腺增生的效果及对性功能的影响  

Effect of ureteral catheterization combination with HLLS in the treatment of UC with BPH and its influence on sexual function

作　　者：徐晓艳 丁燕平 鲁欣[3] XU Xiao-yan;DING Yan-ping;LU Xin(Department of Urology,Nanjing Medical University Fourth Affiliated Hospital,Nanjing Jiangsu 210000,China;Department of Thoracic Surgery,Nanjing Medical University Fourth Affiliated Hospital,Nanjing Jiangsu 210000,China;Department of Nursing,Tianjin Fourth Central Hospital,Tianjin 300000,China)

机构地区：[1]南京医科大学第四附属医院泌尿科,江苏南京210000 [2]南京医科大学第四附属医院胸外科,江苏南京210000 [3]天津市第四中心医院护理部,天津300000

出　　处：《临床和实验医学杂志》2024年第22期2397-2401,共5页Journal of Clinical and Experimental Medicine

基　　金：江苏省科学技术厅计划项目(编号:B202001866)。

摘　　要：目的探究输尿管置管联合钬激光碎石(HLLS)治疗输尿管结石(UC)合并前列腺增生(BPH)的效果及对性功能的影响。方法将2021年6月至2023年6月南京医科大学第四附属医院收治的78例UC合并BPH患者纳入本次回顾性研究,根据治疗方式不同分为研究组(n=43)和对照组(n=35),研究组患者采用输尿管置管联合HLLS治疗,对照组患者采用HLLS治疗,比较两组的围术期指标,手术前后的性功能指标[国际勃起功能评分量表(IIEF5)、中国早泄患者性功能评价表(CIPE)]和前列腺症状[国际前列腺症状评分量表(IPSS)]评分、尿流动力学参数[最大尿流率(Qmax)、最大膀胱测压容量(MCC)]和术后并发症发生情况。结果研究组的术中出血量为(85.10±26.51)mL,少于对照组[(106.32±30.58)mL],研究组的手术时间、血尿时间和住院时间分别为(61.35±22.30)min、(2.50±0.26)d和(5.10±0.34)d,均明显短于对照组[(72.83±26.26)min、(3.21±0.32)d和(7.20±0.43)d],差异均有统计学意义(P<0.05)。术后3个月,两组的IIEF-5评分、CIPE评分均较术前显著升高,IPSS评分均较术前显著下降,且研究组的IIEF-5评分、CIPE评分分别为(9.25±2.74)、(28.24±3.39)分,均显著高于对照组[(8.19±2.41)、(25.06±3.17)分],IPSS评分为(7.33±1.26)分,显著低于对照组[(9.77±1.53)分],差异均有统计学意义(P<0.05)。术后3个月,两组的Qmax、MCC均较术前显著增加,而RU均较术前显著降低,研究组的Qmax、MCC分别为(16.50±1.72)mL/s、(329.59±23.21)mL,均显著高于对照组[(14.17±1.61)mL/s、(312.82±26.54)mL],而RU为(33.15±4.27)mL,显著低于对照组[(40.39±5.09)mL],差异均有统计学意义(P<0.05)。研究组与对照组的术后总并发症发生率比较(6.98%vs.14.29%),差异无统计学意义(P>0.05)。结论输尿管置管联合HLLS治疗UC合并BPH的效果良好,可有效改善患者的性功能和尿动力学指标,且安全性良好。Objective To investigate the effect of ureteral catheterization combination with holmium laser lithotripsy(HLLS)in the treatment of ureteral calculi(UC)with benign prostatic hyperplasia(BPH)and its impact on sexual function.Methods Seventy-eight patients with UC complicated with BPH admitted to the Fourth Affiliated Hospital of Nanjing Medical University from June 2021 to June 2023 were included in this retrospective study and were divided into the study group(n=43)and the control group(n=35)according to the different treatment methods.The study group received ureteral catheterization combination with HLLS,while the control group received HLLS.The perioperative indicators,sexual function indicators[including international index of erectile function(IIEF5),Chinese index of sexual function for premature ejaculation(CIPE)]scores before and after operation,as well as prostate symptom[international prostate symptom score(IPSS)]scores,urodynamic parameters,and postoperative complications were compared.Results The intraoperative blood loss of the study group was(85.10±26.51)mL,which was less than that of the control group[(106.32±30.58)mL],the operation time,hematuria time and hospitalization time of the study group were(61.35±22.30)min,(2.50±0.26)d and(5.10±0.34)d,respectively,which were significantly shorter than those of the control group[(72.83±26.26)min,(3.21±0.32)d and(7.20±0.43)d],and the differences were statistically significant(P<0.05).At 3 months after operation,the IIEF-5 score and CIPE score of the two groups were significantly higher than those before operation,and the IPSS score was significantly lower than that before operation.The IIEF-5 score and CIPE score of the study group were(9.25±2.74)and(28.24±3.39)points,which were significantly higher than those of the control group[(8.19±2.41)and(25.06±3.17)points],and the IPSS score was(7.33±1.26)points,which was significantly lower than that of the control group[(9.77±1.53)points],the differences were statistically significant(P<0.05).At 3 mon

关 键 词：输尿管置管 钬激光碎石 输尿管结石 前列腺增生 性功能 

分 类 号：R699[医药卫生—泌尿科学]