摘要
目的 比较输尿管镜下导尿管留置术和耻骨上膀胱穿刺造瘘术在治疗急诊导尿失败前列腺增生并尿潴留患者的临床疗效.方法 回顾性选取2020年2月至2024年1月遵义市第一人民医院收治的急诊导尿失败的60例前列腺增生并尿潴留患者作为研究对象,根据治疗方案的差异分为观察组(n=30,行输尿管镜下导尿管留置术)和对照组(n=30,行耻骨上膀胱穿刺造瘘术).比较两组患者临床疗效、手术时间、生活质量、排尿情况、疼痛程度、术后并发症.结果 观察组患者临床总有效率为100％,显著高于对照组的66.67％(P<0.05);观察组患者手术所需时长显著长于对照组患者手术所需时长(P<0.05).两组患者手术之前生活质量QOL评分和排尿功能DVSS评分、疼痛程度VSA评分均无显著差异(P>0.05).手术后,观察组患者的QOL评分显著高于对照组(P<0.001),DVSS评分、VSA评分显著低于对照组(P<0.001).观察组术后并发症发生率显著低于对照组(P<0.05).结论 输尿管镜下导尿管留置术虽然手术时间较长,但可明显改善急诊导尿失败的前列腺增生并尿潴留患者的生活质量和排尿功能障碍,降低术后疼痛程度,减少并发症的发生,效果确切.
Abstract
Objective To compare the clinical efficacy of ureteroscopic catheterization and suprapubic cys-tostomy in the treatment of acute urinary retention due to benign prostatic hyperplasia (BPH) in patients who failed emergency catheterization. Methods A retrospective study was conducted on 60 patients with BPH and urinary retention who failed emergency catheterization and were admitted to Zunyi First People's Hospital from February 2020 to January 2024. Patients were divided into an observation group (n=30,receiving ureteroscopic catheteriza-tion) and a control group (n=30,receiving suprapubic cystostomy) based on treatment protocol. Clinical efficacy,surgery time,quality of life (QOL),urinary function,pain level,and postoperative complications were compared between the two groups. Results The overall clinical efficacy rate in the observation group was 100％,signif-icantly higher than the control group's 66.67％ (P<0.05). However,surgery time was significantly longer in the observation group compared to the control group (P<0.05). Preoperative QOL scores,dysfunctional voiding symp-tom scores (DVSS),and visual analogue scale (VAS) pain scores showed no significant differences between the two groups (P>0.05). Postoperatively,the QOL scores in the observation group were significantly higher than those in the control group (P<0.001),while DVSS and VAS scores were significantly lower (P<0.001). The incidence of postoperative complications in the observation group was also significantly lower than that in the control group (P<0.05). Conclusion Although ureteroscopic catheterization requires longer operation time,it markedly im-proves the quality of life and urinary function in patients with BPH and urinary retention who fail emergency cathe-terization,reduces postoperative pain,and lowers the risk of complications,confirming its clinical efficacy.
维普
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