前列腺尿道悬吊术对小体积良性前列腺增生患者下尿路功能、血清炎症-应激因子、并发症的影响  

Effects of Prostatic Urethral Suspension on Lower Urinary Tract Function,Serum Inflammatory Stress Factors and Complications in Small-volume Benign Prostatic Hyperplasia Patients

作　　者：李正平 李永芬 王生鹏 Li Zhengping;Li Yongfen;Wang Shengpeng(Department of Urology,the Fourth People's Hospital of Qinghai Province,Xining 810000,China)

机构地区：[1]青海省第四人民医院泌尿外科,西宁810000

出　　处：《微创泌尿外科杂志》2025年第1期31-37,共7页Journal of Minimally Invasive Urology

基　　金：中国管理科学研究院教育科学研究所科教创新研究重点课题(KJCX11630)。

摘　　要：目的:探究前列腺尿道悬吊术(PUL)对小体积良性前列腺增生(BPH)患者下尿路功能、血清炎症-应激因子以及并发症的影响。方法:选取2022年8月至2023年8月青海省第四人民医院116例小体积BPH患者,采用简易随机化法将其分为对照组(58例)和研究组(58例)。对照组行经尿道前列腺电切术(TURP)治疗,研究组行PUL治疗。比较两组围术期情况、血清炎症-应激因子[脂质过氧化物(LPO)、丙二醛(MDA)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、下尿路功能[残余尿量(PVR)、最大尿流量(Qmax)、最大逼尿肌收缩压(Pdetmax)]、前列腺特异性抗原(PSA)水平[游离PSA(fPSA)、总PSA(tPSA)]、前列腺症状[国际前列腺症状评分(IPSS)评价]、勃起功能[国际勃起功能指数-5(IIEF-5)评价]、生活质量[生活质量评分(QOL)评价]、术后并发症。统计学方法采用t检验和χ^(2)检验。结果:研究组手术、留置尿管、膀胱冲洗及住院时间短于对照组(P<0.05)。术后3 d,研究组血清IL-6、TNF-α、LPO、MDA水平低于对照组(P<0.05);术前、术后6个月两组血清tPSA、fPSA水平比较差异无统计学意义(P>0.05)。术后6个月,研究组PVR低于对照组,Qmax、Pdetmax高于对照组,IPSS、QOL评分低于对照组(P均<0.05),两组IIEF-5评分比较差异无统计学意义(P>0.05)。研究组术后并发症总发生率低于对照组(P<0.05)。结论:相较于TURP术式,PUL治疗小体积BPH手术时间短、创伤小、术后恢复快、并发症少,可有效改善下尿路功能、前列腺症状,提高生活质量。Objective:To investigate the impact of prostatic urethral suspension(PUL)on lower urinary tract function,serum inflammatory-stress markers,and complications in patients with small-volume benign prostatic hyper-plasia(BPH).Methods:A total of 116 patients with small-volume BPH treated at the Fourth People's Hospital of Qinghai Province from August 2022 to August 2023 were enrolled and randomly divided into the control group(58 cases)and the study group(58 cases).The control group received transurethral resection of the prostate(TURP),while the study group underwent PUL treatment.Perioperative data,serum inflammatory-stress factors[lipid peroxi-dation(LPO),malondialdehyde(MDA),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],lower urinary tract function[postvoid residual urine(PVR),maximum urinary flow rate(Qmax),maximum bladder contraction pres-sure(Pdetmax)],prostate-specific antigen(PSA)levels[free PSA(fPSA),total PSA(tPSA)],prostate symp-toms(International Prostate Symptom Score(IPSS)),erectile function(International Index of Erectile Function-5(IIEF-5)),quality of life(Quality of Life(QOL)score),and postoperative complications were compared between the two groups.Statistical analysis was performed using t-tests and chi-square tests.Results:The study group had shorter surgery duration,catheterization time,bladder irrigation time,and hospital stay compared to the control group(P<0.05).Three days after surgery,the study group had lower serum IL-6,TNF-α,LPO,and MDA levels than the control group(P<0.05).There were no significant differences in serum tPSA and fPSA levels between the two groups before surgery and at 6 months postoperatively(P>0.05).At 6 months postoperatively,the study group had lower PVR,higher Qmax and Pdetmax,and lower IPSS and QOL scores compared to the control group(P<0.05),while no significant difference in IIEF-5 scores was found between the two groups(P>0.05).The total incidence of postoperative complications in the study group was lower than that in the control group(P<0.05).Conclusion:

关 键 词：前列腺增生 前列腺尿道悬吊术 经尿道前列腺电切术 下尿路功能 前列腺特异性抗原 并发症 

分 类 号：R697.32[医药卫生—泌尿科学]