膀胱内前列腺突入度对BPH患者TURP手术效果的预测评估作用

摘要

目的：探讨超声测定膀胱内前列腺突入度（IPP）对前列腺增生（BPH）患者行前列腺电切（TURP）手术效果的预测评估作用。方法136例患者因BPH入院行TURP，经腹超声测量IPP，根据IPP程度将患者分为突入组（IPP＞10mm）66例，对照组（IPP≤10mm）70例，比较2组术前前列腺体积（PV）、前列腺特异性抗原（PSA）差异，统计、分析2组术前和TURP术后6个月国际前列腺症状评分（IPSS）、生活质量评分（QoL）、最大尿流率（Qmax）、残余尿量（PVR）变化；多因素分析IPP与手术效果的相关性。结果两组年龄、术前IPSS、QoL相比无差异（P＞0.05），但突入组PV、PSA、Qmax、PVR与对照组相比有统计学差异（P＜0.05），两组TURP术后随访6个月，突入组 IPSS下降、PVR减少和Qmax提高与对照组相比有统计学差异（P＜0.05）；多因素分析显示IPP程度与TURP术后IPSS下降（OR=2.98，95%=1.05~6.89）、Qmax提高（OR=5.96，95%=2.85~9.55）相关。结论IPP程度可影响BPH患者PVR和Qmax，相对于IPP≤10mm，IPP＞10mm的BPH患者TURP术后IPSS下降、PVR减少和Qmax提高更加明显，IPP程度可预测BPH患者TURP术后IPSS下降、Qmax提高。%Objective To evaluate the clinical value of intravesical prostatic protrusion (IPP) for predicting postoperative outcomes of transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia(BPH). Methods Total of 136 BPH patients treated with TURP, who were followed-up for 6 months, were divided into two groups on the basis of the degree of IPP: the IPP group (IPP>10 mm, n=66) and the control group (IPP≤10mm, n=70). Clinical parameters of patients such as the International Prostate Symptom Score (IPSS), quality-of-life (QoL) score, maximum urinary flow rate (Qmax), and postvoid residual urine (PVR) of preoperation and postoperation were collected and analyzed. Multivariate logistic regression analysis was performed to identify whether IPP could predict surgical outcomes of TURP. Results There were no significant difference in preoperative parameters between the two groups except for prostate volume, PSA, Qmax and PVR . Levels of postoperative parameters such as IPSS, Qmax and PVR were higher in the IPP group than that in the control group. QoL score were not significantly different between the two groups. Multivariate logistic regression analysis revealed that the odds ratios (95% confidence interval) of decreased IPSS and increased Qmax in the significant IPP group were 2.98 (95%=1.05~6.89) and 5.96(95%=2.85~9.55), respectively (P=0.035 and 0.028, respectively).Conclusion The degree of IPP can significantly affect prostate volume, IPSS , PVR and Qmax. IPP may be a factor for predicting better postoperative outcomes of IPSS and Qmax.