TURP在良性前列腺增生不同症状阶段的疗效分析

Curative effect analysis of TURP for benign prostatic hyperplasia

关键词:  良性前列腺增生  TURP  IPSS  QOL

Key words:  benign prostatic hyperplasia  TURP  IPSS  QOL

摘要:

目的　回顾性分析经尿道前列腺电切术（transurethral resection of prostate, TURP)在治疗良性前列腺增生（benign prostatic hyperplasia, BPH)不同症状阶段的效果及并发症,探讨TURP在治疗良性前列腺增生症中时机选择。方法　收集行TURP术并有随访的良性前列腺增生患者1126例，根据患者术前主要症状分为储尿期症状组(510例，储尿期症状为主)和排尿期症状组(616例，排尿期症状为主)，分别比较两组TURP手术后疗效及并发症：国际前列腺症状评分(IPSS)、最大尿流率(Qmax)及生活质量指数（QOL）评分及术后短暂尿失禁，尿潴留等并发症的发生率。 结果　储尿期症状组患者术后IPSS评分、最大尿流率Qmax(mL/s)及生活质量指数（QOL）评分较排尿期症状组改善明显（P＜0.05）；术后3个月及1年储尿期症状组的症状缓解率明显优于排尿期症状组（P＜0.05）；术后3个月内排尿期症状组的尿潴留发生率明显高于储尿期症状组（P＜0.05），而储尿期症状组的术后短暂尿失禁发生率高于排尿期症状组（P＜0.05），其他不良反应两组间无明显差异（P＞0.05)；术后1年储尿期症状组尿失禁及尿潴留均缓解，而排尿期症状组尿潴留发生率明显高于储尿期症状组（P＜0.05）。结论　TURP治疗以储尿期症状为主的BPH效果更好，更安全。

Abstract:

Objective　A retrospective analysis was taken to investigate the effect about the transurethral resection of prostate (TURP) in different stages of Benign Prostatic Hyperplasia (BPH).　Methods 1126 patients with BPH who were treated with TURP and followed up were retrospectively analyzed. According to preoperative main symptoms, the patients wth BPH were divided into the Urine Storage Period Group (510 cases, ustorage rinary symptoms) and voiding symptoms group (616 cases, voiding symptoms). Two groups were compared before and after TURP surgery micturition: international prostate symptom score (IPSS), Quality of life index(QOL), maximum urinary flow rate (Qmax) and two groups of postoperative complications. 　Results　The postoperative IPSS score, maximum urine flow rate Qmax(mL/s) and quality of life index (QOL) score of the patients in the urination symptom group were significantly improved compared with the urination symptom group (P<0.05). The effective rate of operation was significantly better than that of urination symptom group in 3 months and 1 year after operation (P<0.05).The incidence of urinary retention was significantly higher in the urination symptoms group than in the urination storage symptoms group within 3 months after surgery (P<0.05), while the incidence of short-term incontinence was significantly higher in the urination storage symptoms group than in the urination symptoms group (P<0.05). There was no significant difference in other adverse reactions between the two groups (P>0.05). Urinary incontinence was relieved in the group with symptoms of urination storage one year after surgery, while the incidence of urinary retention was significantly higher in the group with symptoms of urination storage than in the group with symptoms of urination storage (P<0.05). 　Conclusion　TURP is more effective and safe in the treatment of BPH with storage symptoms.