摘要
目的:探讨经尿道前列腺电切术(TURP)对世居西藏高原不同体积良性前列腺增生(BPH)藏族患者围术期指标、性功能及术后并发症的影响。方法:选择2015年6月至2017年2月西藏自治区人民医院泌尿外科收治的325例因BPH行TURP治疗的世居西藏高原藏族患者纳入研究,非吸氧状态末梢中位血氧饱和度仅为84%,24%的患者有肾积水,40. 3%发生急性尿潴留,术前规律用药比例为19. 1%; 123例行心脏超声检查患者中肺动脉高压患病率为61. 8%。按照前列腺体积分为大体积组(≥80 ml,124例)和小体积组(<80 ml,201例),比较两组患者围手术期指标、术后性功能及并发症发生情况。结果:大体积组患者手术时间明显长于小体积组[(92. 36±26. 35) min vs (56. 28±24. 61) min,P <0. 05],大体积组出血量略高于小体积组[(401. 12±50. 12) ml vs (385. 15±51. 62) ml,P> 0. 05];两组患者术后6个月IPSS评分与术前相比明显下降[大体积组:(22. 13±6. 23)分vs (5. 29±1. 14)分,小体积组:(23. 04±6. 82)分vs (5. 12±1. 28)分,P均<0. 05],Qmax明显改善[大体积组:(17. 46±5. 82) ml/s vs (5. 91±1. 86) ml/s,小体积组:(17. 99±5. 86) ml/s vs (6. 01±1. 92) ml/s,P均<0. 05];大体积组逆行射精发生率显著高于小体积组(48. 39%vs 20. 90%,P <0. 05)。两组术后并发症发生率差异无统计学意义(13. 71%vs 9. 45%,P> 0. 05)。结论:TURP治疗世居西藏高原藏族人群BPH患者,大体积前列腺可取得和小体积前列腺相当的有效性及安全性。
Objective: To investigate the perioperative parameters and postoperative sexual function and complications in native Tibetans undergoing transurethral resection of the prostate( TURP) for BPH with different prostate volumes. Methods: From June 2015 to February 2017,325 native Tibetans with BPH underwent TURP in the People’s Hospital of Tibet Autonomous Region. The patients were aged 59-88 years,with a median oxygen saturation level of 84% in the normal status,24% with hydronephrosis,40. 3% with the history of acute urinary retention,61. 8% with pulmonary hypertension,and 19. 1% taking regular medication preoperatively.According to the preoperative prostate volume( PV),the patients were divided into a large PV( LPV) group( PV ≥80 ml,n = 124)and a small PV( SPV) group( < 80 ml,n = 201). Perioperative parameters and postoperative sexual function and complications were analyzed and compared between the two groups of patients. Results: The operation time was significantly longer in the LPV than in the SPV group( [92. 36 ± 26. 35]vs [56. 28 ± 24. 61]min,P < 0. 05) and the intraoperative blood loss was higher in the former than in the latter( [401. 12 ± 50. 12] vs [385. 15 ± 51. 62] ml,P < 0. 05). Compared with the baseline,at 6 months after operation,the IPSS was significantly decreased in all the patients( 22. 13 ± 6. 23 vs 5. 29 ± 1. 14 in the LPV group,P < 0. 05;23. 04 ± 6. 82 vs 5. 12 ± 1. 28 in the SPV group,P < 0. 05),and the maximum urinary flow rate( Qmax) remarkably improved( [17. 46 ± 5. 82]vs [5. 91 ± 1. 86]ml/s in the LPV group,P < 0. 05; [17. 99 ± 5. 86]vs [6. 01 ± 1. 92]ml/s in the SPV group,P < 0. 05). The incidence rate of retrograde ejaculation was markedly higher in the LPV than in the SPV group postoperatively( 48. 4% vs 20. 9%,P < 0. 05). No statistically significant differences were observed between the two groups of patients in the incidence of postoperative complications( 13. 71% vs 9. 45%,P > 0. 05). Conclusion: TURP is effective and safe for the treatment of BPH native Tibetans with different prostate volumes.
作者
王峰
王晋龙
罗锋
斯郎江村
谷亚龙
孟一森
WANG Feng;WANG Jin-long;LUO Feng;SILANG Jiang-cun;GU Ya-long;MENG Yi-sen(Department of Urology,People's Hospital of Tibet Autonomous Region,Lhasa,Tibet 850000,China;Department of Urology,Peking University First Hospital,Beijing100034,China)
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2018年第12期1078-1083,共6页
National Journal of Andrology
关键词
经尿道前列腺电切术
良性前列腺增生
前列腺体积
围术期指标
性功能
高原
藏族
transurethral resection of the prostate
benign prostate hyperplasia
prostate volume
perioperative parameters
sex ual function
high altitude
native Tibetan
