摘要
目的:探讨经尿道前列腺电切术结合补中益气丸治疗高危大体积良性前列腺增生的疗效及术后尿道狭窄的高危因素。方法:选择2017年1月—2018年1月收治的56例高危大体积前列腺增生患者作为观察对象,按随机数字表法分为两组,各28例。对照组行开放前列腺切除术,观察组行经尿道前列腺电切术,观察治疗效果。两组术后均给予补中益气丸治疗。另选2015年1月—2018年1月收治的138例经尿道前列腺电切术高危大体积前列腺增生患者,运用有序Logistic回归分析统计学方法分析术后尿道狭窄的高危因素。结果:观察组手术时间长于对照组,术中出血量少于对照组,持续膀胱冲洗时间、留置尿管时间短于对照组,差异均有统计学意义(P<0.05)。两组术后并发症发生率差异不明显(P>0.05)。术后半年两组IPSS、Qmax、PVR均较术前改善,但两组IPSS、Qmax、PVR差异不明显(P>0.05)。经logistics回归分析显示,术前尿路感染、术前反复应用抗生素、术后尿路感染、导尿管留置时间是高危大体积前列腺增生患者行TURP术后尿道狭窄的高危因素(P<0.05)。结论:经尿道前列腺电切术结合补中益气丸治疗高危大体积良性前列腺增生疗效确切,相对开放前列腺切除术具有出血少、持续膀胱冲洗时间少、留置尿管时间短的优势,但手术时间相对较长,临床疗效基本相当,可在临床中应用推广。
Objective:To investigate the efficacy of transurethral resection of prostate in the treatment of high-risk large benign prostatic hyperplasia and the risk factors of postoperative urethral stricture.Methods:Fifty-six high-risk patients with large volume prostatic hyperplasia admitted from January 2017 to January 2018 were selected as observation objects,and were divided into two groups according to the random number table method,with 28 cases in each group.Open prostatectomy was performed in the control group and transurethral resection was performed in the study group.One hundred and thirty-eight cases of high-risk large-volume prostatic hyperplasia after transurethral resection of prostate were selected from January 2015 to January 2018.Orderly Logistic regression analysis was used to analyze the risk factors of postoperative urethral stricture.Results:The duration of operation in the study group was longer than that in the control group,the amount of intraoperative blood loss was less than that in the control group,the duration of continuous bladder irrigation and indwelling catheter was shorter than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).IPSS,Qmax and PVR in the two groups were improved half a year after surgery compared with that before surgery,but there was no significant difference in IPSS,Qmax and PVR between the two groups(P>0.05).According to logistics regression analysis,preoperative urinary tract infection,preoperative repeated application of antibiotics,postoperative urinary tract infection,and catheter indwelling time are high risk factors for urethral stricture in high-risk patients with massive prostatic hyperplasia after TURP(P<0.05).Conclusion:Transurethral resection of prostate is effective in the treatment of high-risk large-volume benign prostatic hyperplasia.Compared with open prostatectomy,it has the advantages of less bleeding,less continuous bladder irrigation time and shorter indwelling urinary tube time.
作者
许春华
赖亮
李小斌
XU Chun-hua;LAI Liang;LI Xiao-bin(Third Surgical Department,People's Hospital of Guangchang County,Guangchang 344900,China)
出处
《江西中医药大学学报》
2020年第4期50-53,共4页
Journal of Jiangxi University of Chinese Medicine
关键词
经尿道前列腺电切术
高危
大体积
良性前列腺增生
术后尿道狭窄
Transurethral Resection of Prostate
High Risk
Large Volume
Benign Prostatic Hyperplasia
Postoperative Urethral Stricture
