经尿道前列腺等离子电切术联合膀胱颈内切开术对小体积前列腺增生患者膀胱动力学及逼尿肌收缩能力的影响分析  

Analysis of the effects of transurethral plasmakinetic resection of the prostate combined with transurethral resection of the bladder neck on bladder dynamics and detrusor contractility in patients with small volume prostatic hyperplasia

作　　者：代鹏 DAI Peng(Department of Urology,Yicheng District People's Hospital,Zaozhuang 277300,China)

机构地区：[1]枣庄市峄城区人民医院泌尿外科,277300

出　　处：《中国现代药物应用》2025年第6期12-16,共5页Chinese Journal of Modern Drug Application

摘　　要：目的观察小体积前列腺增生患者采用经尿道前列腺等离子电切术联合膀胱颈内切开术治疗对患者膀胱动力学及逼尿肌收缩能力的影响。方法选取70例小体积前列腺增生男性患者,以随机抽签法分成对照组(34例)和观察组(36例)。对照组以经尿道前列腺等离子电切术作为治疗方案,观察组在对照组基础上联合膀胱颈内切开术作为治疗方案。比较两组围术期指标,手术前后疼痛介质、国际前列腺症状量表(IPSS)评分、膀胱动力学及逼尿肌功能。结果两组术中出血量、切除质量、导尿管留置时间比较无明显差异(t=0.949、0.283、0.276,P>0.05)。两组术后3 d血清P物质、前列腺素E2水平比较无明显差异(t=0.388、0.912,P>0.05)。观察组术后30 d排尿不尽、排尿间隔<2 h、间断性排尿、憋尿困难、尿线变细、排尿费力、夜尿次数增多评分分别为(2.03±0.41)、(1.96±0.43)、(2.09±0.76)、(2.06±0.48)、(1.68±0.71)、(1.96±0.65)、(1.60±0.58)分,均比对照组的(2.47±0.69)、(2.34±0.51)、(2.57±0.83)、(2.53±0.60)、(2.27±0.86)、(2.34±0.87)、(2.18±0.71)分更低(t=3.265、3.377、2.526、3.629、3.137、2.078、3.752,P<0.05)。观察组术后30 d最大膀胱尿容量、膀胱顺应性、最大尿流率分别为(372.36±30.02)ml、(33.80±3.10)ml/cm H_(2)O(1 cm H_(2)O=0.098 kPa)、(21.60±2.75)ml/s,均比对照组的(351.59±28.74)ml、(31.75±3.23)ml/cm H_(2)O、(19.47±3.52)ml/s更高(t=2.954、2.710、2.830,P<0.05)。观察组术后30 d逼尿肌收缩力(49.19±6.27)cm H_(2)O、最大逼尿肌压力(15.37±3.46)cm H_(2)O均比对照组的(45.31±5.16)、(12.42±2.67)cm H_(2)O更高(t=2.818、3.977,P<0.05)。结论经尿道前列腺等离子电切术联合膀胱颈内切开术能够改善小体积前列腺增生患者临床症状,有效恢复患者膀胱功能及逼尿肌功能。Objective To observe the effects of transurethral plasmakinetic resection of the prostate combined with transurethral resection of the bladder neck on bladder dynamics and detrusor contractility in patients with small volume prostatic hyperplasia.Methods 70 male patients with small-volume prostatic hyperplasia were included in the study.They were divided into control group(34 cases)and observation group(36 cases)according to random lottery method.The control group was treated with transurethral plasmakinetic resection of the prostate,and the observation group was treated with transurethral resection of the bladder neck on the basis of the control group.Comparison of perioperative indicators,pain mediators,International Prostate Symptom Scale(IPSS)scores,bladder dynamics and detrusor function before and after surgery between the two groups.Results There were no significant differences in the amount of blood loss,the quality of resection and the indwelling time of catheter between the two groups(t=0.949,0.283,0.276;P>0.05).At 3 d after surgery,there were no significant differences in serum substance P and prostaglandin E_(2) levels between the two groups(t=0.388,0.912;P>0.05).At 30 d after surgery,the scores of incomplete urination,interval of urination<2 h,intermittent urination,difficulty in holding urine,thin urine line,difficulty urinating,and increased nocturia frequency were (2.03±0.41), (1.96±0.43), (2.09±0.76), (2.06±0.48), (1.68±0.71), (1.96±0.65), and (1.60±0.58) points in the observation group, which were lower than (2.47±0.69), (2.34±0.51), (2.57±0.83), (2.53±0.60), (2.27±0.86), (2.34±0.87), and (2.18±0.71) points in the control group (t=3.265, 3.377, 2.526, 3.629, 3.137, 2.078, 3.752;P<0.05). At 30 d after surgery, the bladder capacity, bladder compliance, and maximum urinary flow rate were (372.36±30.02) ml, (33.80±3.10) ml/cm H_(2)O (1 cm H_(2)O=0.098 kPa), and (21.60±2.75) ml/s, which were higher than (351.59±28.74) ml, (31.75±3.23) ml/cm H_(2)O, (19.47±3.52) ml/s in the control

关 键 词：经尿道前列腺等离子电切术 膀胱颈内切开术 小体积前列腺增生 膀胱动力学 逼尿肌收缩力 

分 类 号：R699.8[医药卫生—泌尿科学]