摘要
目的 探讨经尿道前列腺柱状水囊扩开术在不同程度心肺功能异常的高龄前列腺增生(BPH)患者中的临床应用效果.方法 选择75 例BPH患者作为研究对象,分为轻微心肺功能异常组、中度心肺功能异常组和重度心肺功能异常组,所有患者均行经尿道前列腺柱状水囊扩开术治疗,比较三组患者的下尿路症状(LUTS)、国际前列腺症状评分(IPSS)、超声残余尿量、最大尿流率、生活质量、及术后并发症发生率.结果 轻微心肺功能异常组憋尿困难、夜尿、尿不尽感、尿线变细、间断性排尿评分低于中度心肺功能异常组(t分别=5.19、6.14、6.03、5.33、6.02,P均＜0.05);中度心肺功能异常组憋尿困难、夜尿、尿不尽感、尿线变细、间断性排尿评分低于重度心肺功能异常组(t分别=6.03、5.34、4.09、6.32、5.22,P均＜0.05).轻微心肺功能异常组手术后IPSS评分、残余尿量低于中度心肺功能异常组,生活质量评分及最大尿流率高于中度心肺功能异常组(t分别=4.59、5.11、-5.22、-5.03,P均＜0.05),中度心肺功能异常组手术后IPSS评分、残余尿量低于重度心肺功能异常组,生活质量评分及最大尿流率高于重度心肺功能异常组(t分别=5.59、5.12、-6.03、-5.77,P均＜0.05).三组随访期间尿失禁、尿潴留、尿路感染及术后出血总发生率比较,差异无统计学意义(χ2=1.04,P＞0.05).结论 经尿道前列腺柱状水囊扩开术用于轻微心肺功能异常高龄BPH患者中效果最佳,有助于改善患者下尿路症状,改善患者尿动力学水平,提高患者生活质量,降低术后并发症发生率.
Abstract
Objective To explore the clinical application effect of transurethral prostate cystectomy in elderly benign prostatic hyperplasia(BPH)patients with different degree of cardiopulmonary dysfunction.Methods A total of 75 pa-tients with BPH were selected as the study subjects,and divided into mild cardiopulmonary dysfunction group,moderate cardiopulmonary dysfunction group,and severe cardiopulmonary dysfunction group.All patients underwent transurethral prostate cystectomy.The lower urinary tract(LUTS)symptoms,international prostate symptom score(IPSS),ultrasound residual urine volume,maximum urine flow rate,quality of life,and incidence of postoperative complications were com-pared among the three groups.Results The scores of dyspuria,nocturnal urination,incontinence,thin urine line and in-termittent urination in mild cardiopulmonary dysfunction group were lower than those in moderate cardiopulmonary dys-function group(t=5.19,6.14,6.03,5.33,6.02,P＜0.05).The scores of dyspuria,nocturnal urination,incontinence,thin urine line and intermittent urination in moderate group were lower than those in severe cardiopulmonary dysfunction group(t=6.03,5.34,4.09,6.32,5.22,P＜0.05).The IPSS score and residual urine volume in the mild cardiopulmonary dysfunction group were lower than those in the moderate cardiopulmonary dysfunction group,and QoL score and maximum urine flow rate were higher than those in the moderate cardiopulmo-nary dysfunction group(t=4.59,5.11,-5.22,-5.03,P＜0.05).The IPSS score and residual urine volume of the moderate cardiopulmonary dysfunction group were lower than those of the severe cardiopulmonary dysfunction group,and QoL score and maximum urine flow rate were higher than those of the severe cardiopulmonary dysfunction group(t=5.59,5.12,-6.03,-5.77,P＜0.05).There was no significant dif-ference in the total incidence of urinary incontinence,urinary retention,urinary tract infection and postoperative bleeding among the three groups during follow-up(χ2=1.04,P＞0.05).Conclusion Transurethral column water capsule expan-sion of prostate can improve lower urinary tract symptoms,improve urodynamics,improve quality of life and reduce the incidence of postoperative complications in elderly BPH patients,and the best effect is found in patients with mild cardio-pulmonary dysfunction.
维普
万方数据