经尿道前列腺剜除术治疗逼尿肌无力的前列腺增生症的疗效观察

摘要

Objective:To investigate the clinical efficacy and safety of transurethral enucleation and resection of the prostate (TUERP)in the treatment of benign prostatic hyperplasia (BPH)patients with acontractile detrusor (ACD).Methods:Clinical parameters were analyzed in 36 BPH patients with ACD,and statistical analyses were conducted after recording the clinical outcomes before and after operation.The statistic analysis indexes included in-ternational prostate symptom score (IPSS),maximum flow (Qmax ),post void residual urine volume (PVR),and application of indwelling catheter.Results:The analysis results of clinical outcomes showed that after TUERP treat-ment,24 and 33 patients got normal voiding after three months and six months of follow-up periods,respectively. As compared with preoperative IPSS,Qmaxand PVR (25.7±4.4,3.4±2.9 mL/s,and 164.56±42.6 mL),they were significantly increased at 3rd month after surgery (11.30±1.30,15.44±2.98 mL/s,and <50 mL),and the follow-up data got more significant improvements at 6th month after surgery (10.7±4.4,18.44±3.18 mL/s,and<50 mL)(P<0.05 for all).Conclusions:TUERP is regarded as a fairly ideal method for BPH patients with ACD. However,the long-term efectiveness of TUERP is yet to be further proved by greater clinical experience with long-term follow-up period.%目的：：探讨经尿道前列腺剜除术治疗伴尿肌无力(ACD)的前列腺增生症(BP H )的临床疗效。方法：回顾性分析行经尿道前列腺剜除术治疗的36例伴 ACD的前列腺增生患者,记录围手术期、术后3个月、6个月临床资料(包括 IPSS、Qmax、膀胱剩余尿及留置导尿管情况),对所测指标进行统计学分析。结果：36例患者中,术后3个月24例患者能自行排尿(24/36)；术后 6个月,33例患者能自行排尿(33/36),另外 3例因脑血管意外卧床不能自行排尿,留置膀胱造瘘管。各项统计指标与术前比较均差异有统计学意义(P＜0.05),其中 IPSS评分术前为(25.7±2.4)分、术后3个月为(11.30±1.30)分、术后 6个月为(10.7±4.4)分,较术前均有明显改善；Qmax术前(3.4±2.9)ml/s、术后3个月(15.44±2.98)ml/s、术后 6个月(18.44±3.18)ml/s,术后较术前均显著提高；膀胱剩余尿术前(164.56±42.6)ml,术后3个月和 6个月均小于50 ml,明显减少至正常。结论：经尿道前列腺剜除术治疗BP H 伴ACD的疗效确切,术后可以自行排尿,生活质量提高,但仍需要更多的临床经验及更长时间的随访。