TURP及HoLEP对合并膀胱逼尿肌活动过度的BPH手术效果的比较

发布时间：2018-01-21 04:35

本文关键词： 膀胱逼尿肌活动过度经尿道前列腺电切术经尿道钬激光前列腺剜除术良性前列腺增生　出处：《中华男科学杂志》2016年08期 　论文类型：期刊论文

【摘要】：目的:比较分析经尿道前列腺电切术(TURP)及经尿道钬激光前列腺剜除术(Ho LEP)对合并膀胱逼尿肌活动过度的良性前列腺增生(BPH)的手术效果。方法:入组患者均为BPH合并膀胱逼尿肌活动过度,51例采用TURP,58例采用Ho LEP,评估两组患者在术后恢复期及术后3、6个月的排尿情况。结果:两组患者术前血PSA水平、前列腺体积、国际前列腺症状评分(IPSS)、生活质量(Qo L)评分无显著差异,但是膀胱有效容量TURP组[(315±59)ml]优于Ho LEP组[(287±76)ml](P0.05)。术后评估两组患者储尿期症状均改善明显,TURP组IPSS评分中,储尿期评分从术前的(12.6±4.9)分降低到术后3个月的(7.5±3.9)分和术后6个月的(6.1±4.2)分;Ho LEP组储尿期评分从术前的(13.7±5.7)分降低到术后3个月的(7.9±4.2)分和术后6个月的(7.0±5.1)分,均有显著性差异(P均0.01)。Ho LEP组术后留置导尿管天数[(2.7±0.8)d vs(5.1±1.2)d]、术后膀胱挛缩天数[(4.1±1.9)d vs(5.8±2.4)d]、术后住院天数[(4.4±1.8)d vs(5.9±2.5)d]、术后3个月患者最大尿流率的改善情况[Ho LEP组术前为(7.9±3.7)ml/s,术后3个月为(16.8±4.3)ml/s;TURP组术前为(8.6±3.2)ml/s,术后3个月为(14.6±4.3)ml/s]均优于TURP组,差异均有统计学意义(P均0.05)。结论:TURP和Ho LEP均能改善膀胱功能和膀胱逼尿肌活动过度,在术后恢复期内,Ho LEP手术较有优势,但是在术后3个月及术后6个月,两组手术改善排尿情况接近。
[Abstract]:Objective: to compare the effects of transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (Ho LEP) on benign prostatic hyperplasia (BPH) complicated with hyperactivity of bladder detrusor. Methods: all the patients were BPH complicated with hyperactivity of bladder detrusor muscle. Fifty-one patients were treated with turpin and 58 patients were treated with Hole to evaluate the urination status of the two groups during the recovery period and 3 and 6 months after operation. Results: the serum PSA level and prostate volume were measured in the two groups before operation. There was no significant difference in international prostate symptom score (IPSS) and quality of life (QO L) score, but there was no significant difference in bladder effective volume (TURP). [> 315 卤59ml] was superior to Ho LEP group. [After operation, the symptoms of urine storage in both groups were improved significantly, and the IPSS score of TURP group was significantly improved. The score of urine storage period decreased from 12.6 卤4.9 before operation to 7.5 卤3.9 at 3 months after operation and 6.1 卤4.2 at 6 months after operation. The score of Ho LEP group decreased from 13.7 卤5.7 before operation to 7.9 卤4.2 at 3 months after operation and 7.0 卤5.1 at 6 months after operation. There was significant difference in the days of indwelling catheter in LEP group (P < 0.01). Ho LEP group. [2. 7 卤0. 8 d vs(5.1 卤1. 2 d], postoperative bladder contracture days. [4. 1 卤1. 9 vs(5.8 卤2. 4 d], postoperative hospitalization days. [The improvement of maximal uroflow rate was observed 3 months after operation. [In Ho LEP group, it was 7.9 卤3.7 ml / s before operation and 16.8 卤4.3 ml / s at 3 months postoperatively. The TURP group was superior to the TURP group in preoperative (8.6 卤3.2) ml / s and postoperative 3 months (14.6 卤4.3 ml / s). Conclusion both LEP and TURP can improve bladder function and detrusor hyperactivity. Ho LEP operation was superior, but the improvement of urination in the two groups was similar at 3 months and 6 months after operation.
【作者单位】：湖州市第一人民医院泌尿外科;浙江大学医学院附属第二医院泌尿外科;
【基金】：浙江省卫生厅医药课题(2016KYA093)~~
【分类号】：R699.8
【正文快照】： Supported by a grant from The Department of Health of Zhejiang Province(2016KYA093).Correspondence to:WANG Rong-jiang,email:13567228765@163.comReceived:February 14,2016;accepted:May 17,2016男性下尿路症状(LUTS)是老年男性的一个常见症状,症状越重,对生活质量

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