前列腺切除术治疗良性前列腺增生合并膀胱过度活动症患者的夜尿症疗效

摘要

目的 探讨前列腺切除术对良性前列腺增生(BPH)患者膀胱过度活动症(OAB)症状的夜尿症疗效.方法 收集2006年6月至2007年12月因BPH行前列腺切除术患者的临床资料,比较术前和术后3～6个月的夜尿次数、夜间开始入睡到第1次醒来排尿的时间(HUS)、夜尿症生活质量(N-QOL)评分、国际前列腺症状评分(IPSS)和生活质量(QOL)评分等指标的变化.结果 入选125例,术后完成随访73例,其中术前夜尿次数≥2次者有67例,对其疗效指标进行统计学分析:接受经尿道前列腺电切术56例,耻骨上前列腺切除术11例;夜尿次数由(4.2±2.4)次减少至(2.2±1.0)次(P＜0.01);HUS由(1.8±0.7)h延长至(3.0±1.4)h(P＜0.01);N-QOL评分由30±10增加至40±7(P＜0.01);IPSS评分由23±5下降至8±5(P＜0.01);QOL评分由4.4±0.7下降至1.5±1.0(P＜0.01).结论 前列腺切除术能有效地改善BPH患者OAB症状的夜尿症,提高他们的睡眠质量和生活质量.%Objective To explore the effect of prostatectomy on nocturia in patients with benign prostatic hyperplasia ( BPH ). Methods The data of patients who had received prostatectomy for BPH between June 2006 and December 2007 were collected. Nocturia severity was assessed preoperatively and 3 to 6 months after prostatectomy by the number of nocturia events, the time from falling sleep to the first awakening to void (hours of undisturbed sleep,HUS), the score of the nocturia quality of life (N-QOL)questionnaire,the International Prostatic Symptom Score(IPSS) and the quality of life(QOL) score. Results One hundred and twenty five cases were included. Of them, 73 patients finished the follow-up completely. There were 62 patients whose number of nocturia events before the operation was equal or more than 2. The data from these 62 patients were analyzed. Of them, 56 patients underwent transurethral resection of prostate, the remaining 11 patients suprapubic prostatectomy. Significant improvement (P ＜0. 01 ) was noted in all the following parameters after treatment: the number of nocturia events decreased from4.2 ±2.4 to 2.2± 1.0,HUS increased from (1.8 ±0.7) h to (3.0 ±1.4) h,N-QOL score raised from 30 ± 10 to 40 ± 7, IPSS decreased from 23 ± 5 to 8 ± 5, and QOL score fell down from 4. 4 ± 0. 7 to 1.5 ± 1. 0. Conclusion The prostatectomy can markedly improve the symptoms of nocturia, sleep and life quality in the BPH patients who accompanied with nocturia.