经尿道棒状水囊前列腺扩开术治疗 良性前列腺增生的临床疗效分析

Therapeutic effect of transurethral columnar balloon catheter in treating benign prostatic hyperplasia

摘要:

目的 探讨应用经尿道棒状水囊前列腺扩开术治疗良性前列腺增生（BPH）的临床疗效。方法 回顾性分析2016 年10 月—2017 年7 月遂宁市中心医院应用经尿道棒状水囊前列腺扩开治疗的12 例BPH 患 者的临床资料。观察并记录患者的手术时间、尿管留置时间、术后住院时间及围手术期并发症情况，对患 者手术前后失血量、国际前列腺症状评分（IPSS）、生活质量指数（QOL）评分及最大尿流率（Qmax）进行 随访评估。结果 所有患者手术均获成功。患者年龄62 ～ 94 岁，平均76.5 岁。手术时间15 ～ 32 min，平 均22.6 min。术后尿管留置3 ～ 5 d，平均3.6 d。术后住院时间4 ～ 7 d，平均5.6 d。所有患者术后随访2 ～ 9 个 月，中位随访时间6 个月，排尿困难症状较术前改善，无性逆行射精、无功能障碍、无尿道狭窄、无迟发性大出 血及永久性尿失禁等症状发生。手术前后血红蛋白浓度比较，差异无统计学意义（P >0.05）；术前IPSS 平均 （19.4±4.6）分，术后平均（7.2±2.6）分，手术前后IPSS 比较，差异有统计学意义（P <0.05）；术前QOL 评 分平均（4.8±1.2）分，术后平均（2.0±0.6）分，手术前后QOL 评分比较，差异有统计学意义（P <0.05）。 Qmax 术前（4.2±0.6）ml/s 升至术后（14.2±2.6）ml/s，手术前后Qmax 比较差异有统计学意义（P <0.05）。结 论 经尿道棒状水囊前列腺扩开术是治疗BPH 的一种安全有效可选择微创手术方式，其创伤小、术中出血量 少、手术和术后住院时间短、恢复快及术后并发症发生率低。

Abstract:

Objective To evaluate the therapeutic efficacy of transurethral columnar balloon catheter in treating benign prostatic hyperplasia. Methods Totally 12 patients with benign prostatic hyperplasia who were admitted into Suining Central Hospital during October 2016 to July 2017 were enrolled in this study. All patients received transurethral columnar balloon catheter for dilation of prostate. Operation time, blood loss, duration of urinary catheter, postoperative hospital stay and perioperative complications were recorded. The pre- and post-operative score of IPSS, QOL, Qmax were evaluated. Results All patients underwent surgery successfully. Age ranged from 62 to 94 years old, with a mean age of 76.5 years old. The mean operative time was 22.6 min (15-32 min). Mean time of postoperative urinary catheterization was 3.6 d (3-5 d). Mean of postoperative hospital stay was 5.6 d (3-5 d). Patients were followed up from 2 months to 9 months with the median follow-up time of 6 months. Symptoms of dysuria were alleviated significantly without retrograde ejaculation, sexual dysfunction, urethral stricture, delayed hemorrhage and permanent urinary incontinence. No obvious difference in hemoglobin concentration were identified before and after operation [(124.6 ± 2.2) g/L vs (123.4 ± 2.0) g/L, P > 0.05, respectively). Patients experienced dramatic decrease of IPSS, QOL post-surgery when compared with those prior to any treatments [(7.2 ± 2.6) vs (19.4 ± 4.6) P < 0.05; (2.0 ± 0.6) vs (4.8 ± 1.2), P < 0.05, respectively). Qmax was enhanced dramatically after surgery compared with that prior to any treatments (4.2 ± 0.6) ml/s vs (14.2 ± 2.6) ml/s, P < 0.05, respectively]. Conclusions Transurethral columnar balloon catheter is a safe and effective mini-invasive therapy for patients with benign prostatic hyperplasia.