前列腺动脉栓塞术与经尿道前列腺切除术治疗 前列腺增生的疗效及对患者性生活能力的影响

Effects of prostatic arterial embolization and transurethral prostate resection on sexual life of patients with benign prostatic hyperplasia

摘要:

目的 比较前列腺动脉栓塞术与经尿道前列腺切除术治疗前列腺增生的疗效及对患者性生活能 力的影响。方法 选取2017 年1 月—2019 年1 月宝鸡市人民医院确诊的136 例前列腺增生患者作为研究对象， 随机分为观察组和对照组，各68 例。观察组行前列腺动脉栓塞术，对照组行经尿道前列腺切除术。随访6 个月， 比较两组治疗前后的主观及客观症状改善情况，观察两组并发症及性功能障碍发生情况。结果 观察组治疗 前后勃起功能专项量表评分的差值较对照组高（P <0.05）。两组治疗前后最大尿流率、最大逼尿肌压力及膀 胱残余尿量的差值比较，差异无统计学意义（P >0.05）。两组治疗前后前列腺体积、血清前列腺特异性抗原 的差值比较，差异无统计学意义（P >0.05）。观察组并发症发生率、性功能障碍发生率较对照组低（P <0.05）。 结论 前列腺动脉栓塞治疗前列腺增生的疗效及安全性均优于经尿道前列腺切除术，前者对患者性生活能力 的影响较小，在提高生活质量上具有优势，值得在临床上予以重视。

Abstract:

Objective To compare the effects of prostatic arterial embolization and transurethral prostate resection on sexual life of patients with benign prostatic hyperplasia. Methods A total of 136 patients with benign prostatic hyperplasia diagnosed in our hospital from January 2017 to January 2019 were selected as the research subjects and randomly divided into observation group and control group, 68 cases for each group; observation group underwent prostate arterial embolization, and control group underwent transurethral resection of the prostate; After followed up for 6 months, subjective and objective symptoms were compared before and after treatment between the two groups. The incidence of complications and sexual dysfunction were recorded. Results The patients in both groups successfully completed the treatment and are followed up. The difference between the international prostate symptom score (IPSS) score and quality of life (QOL) score of the observation group and the control group before and after treatment was compared, and no significant difference was found (P > 0.05); the difference between the erectile function do-main of the IIEF (IIEF-EF) scores in the observation group before and after treatment was greater than that in the control group, and the difference was statistically significant (P < 0.05); the maximum urine flow rate (Qmax), the maximum detrusor pressure (MDP), and the postvoid residual volume (PVR) in the observation group and the control group were statistically significant (P < 0.05); the differences in prostate volume (PV) and serum prostate specific antigen (PSA) between the observation group and the control group before and after treatment were statistically significant (P < 0.05); the incidence of complications and sexual dysfunction in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). Conclusions Prostatic arterial embolization is more effective and safer than transurethral prostatectomy in treating benign prostatic hyperplasia. The former has less impact on patients’ sexual ability and advantages in improving quality of life. It deserves clinical application.