TURP联合超选择性前列腺动脉栓塞治疗重度BPH的临床效果

doi:10.3969/j.issn.1671-7171.2022.03.014

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摘要【目的】探讨经尿道前列腺切除术(TURP)联合超选择性前列腺动脉栓塞(PAE)治疗重度前列腺增生症(BPH)的临床效果。【方法】回顾性分析2018年1月至2020年12月本院收治的113例重度BPH患者的临床资料,根据手术方案的不同将其分为观察组(行选择性PAE联合TURP治疗,n=57)和对照组(行TURP治疗,n=56)。比较两组患者围术期指标及并发症发生情况,并比较两组患者氧化应激指标、国际前列腺症状评分(IPSS),尿动力学指标[最大尿流率(Qmax)、残余尿量(RUV)]及生活质量(QOL评分)、勃起功能(IIFE-5评分)。【结果】观察组TURP手术时间、术后尿管留置时间、膀胱持续冲洗时间、住院时间、TURP术中出血量均低于对照组,差异均有统计学意义(P<0.05)。术前及TURP术后1 d、5 d,两组患者氧化应激指标比较,差异无统计学意义(P>0.05);TURP术后1 d,两组患者血清皮质醇、去甲肾上腺素、白细胞介素-6、肿瘤坏死因子-α水平高于术前(P<0.05)。TURP术后1个月,两组患者QOL、IIFE-5评分及Qmax高于术前,RUV低于术前,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。【结论】TURP联合超选择性PAE治疗重度BPH的临床效果显著,具有术中出血少、切除效率高、并发症少等优势,患者术后生活质量、勃起功能良好。

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关键词 ：前列腺增生/外科学, 电外科手术, 经尿道前列腺切除术/方法, 栓塞, 治疗性

Abstract：【Objective】To investigate the clinical effect of transurethral prostatectomy (TURP) combined with superselective prostate arterial embolization (PAE) in the treatment of severe benign prostatic hyperplasia (BPH). 【Methods】 The clinical data of 113 patients with severe BPH treated in our hospital from January 2018 to December 2020 were analyzed retrospectively. According to different surgical schemes, they were divided into observation group (treated with selective PAE combined with TURP, n=57) and control group (treated with TURP, n=56). The perioperative indexes and complications were compared between the two groups; The indexes of oxidative stress, International Prostate Symptom Score (IPSS), urodynamic indexes [maximum urinary flow rate (Qmax), residual urine volume (RUV)], quality of life (QOL score) and erectile function (IIFE-5 score) were compared between the two groups.【Results】The operation time of TURP, the indwelling time of urinary catheter, the continuous washing time of bladder, the length of hospital stay and the amount of bleeding during TURP in the observation group were lower than those in the control group (P<0.05). There was no significant difference in oxidative stress indexes between the two groups before operation and 1 and 5 days after TURP (P>0.05); One day after TURP, the level of serum cortisol, norepinephrine, interleukin-6 and tumor necrosis factor-αin the two groups was higher than that before operation (P<0.05). One month after TURP, QOL,IIFE-5 scores and Qmax of the two groups were higher than those before TURP, and RUV was lower than that before TURP (P<0.05). The incidence of complications in the observation group was lower than that in the control group (P<0.05).【Conclusion】TURP combined with superselective PAE has significant clinical effect in the treatment of severe BPH. It has the advantages of less intraoperative bleeding, high resection efficiency and less complications. The patients have good postoperative quality of life and erectile function.

Key words： Prostatic Hyperplasia/SU Electrosurgery Transurethral Resection of Prostate/MT Embolization, Therapeutic

收稿日期: 2021-04-07

中图分类号:

R697.3

通讯作者: * E-mail:51859773@qq.com

引用本文:

焦林, 陈广瑜, 傅崇德, 高辉, 谢圣陶, 党亚东, 汤尧. TURP联合超选择性前列腺动脉栓塞治疗重度BPH的临床效果[J]. 医学临床研究, 2022, 39(3): 370-373.
JIAO Lin, CHEN Guang-yu, FU Chong-de, et al. Clinical Effect of TURP Combined with Superselective Prostate Artery Embolization in the Treatment of Severe BPH. JOURNAL OF CLINICAL RESEARCH, 2022, 39(3): 370-373.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.03.014 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I3/370

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