CAJ | 학술논문

目的探讨伴有下尿路症状(LUTS)的良性前列腺增生症(BPH)的科学治疗选择.方法将2006年1月至2007年12月伴有LUTS的BPH患者209例,根据患者意愿分为两组,分别采用经尿道手术(A组,115例)和盐酸坦索罗辛治疗(B组,94例).治疗前后采用问卷形式,比较两组患者国际前列腺症状评分(IPSS)、生活质量(QOL)评分、最大尿流率(Q_(max))及国际勃起功能评分5(IIEF-5)和治疗总体满意率.结果两组患者均获得随访,平均随访15个月(10-22个月).治疗后两组IPSS、QOL评分和总体满意率比较差异无统计学意义,但A组的Q_(max)高于B组[(20.6±2.8)ml/s比(17.1±3.2)ml/s,P＜0.05],而B组的IIEF-5低于A组[(16.5±4.7)分比(19.3±3.4)分,P＜0.05].结论对伴有LUTS的BPH患者,治疗前应重视患者性功能要求和评估,科学选择治疗措施.盐酸坦索罗辛在改善LUTS的同时可明显改善患者性功能,经尿道手术虽可有效解除膀胱出口梗阻,但可导致勃起功能下降.
목적 탐토반유하뇨로증상(LUTS)적량성전렬선증생증(BPH)적과학치료선택.방법 장2006년1월지2007년12월반유LUTS적BPH환자209례,근거환자의원분위량조,분별채용경뇨도수술(A조,115례)화염산탄색라신치료(B조,94례).치료전후채용문권형식,비교량조환자국제전렬선증상평분(IPSS)、생활질량(QOL)평분、최대뇨류솔(Q_(max))급국제발기공능평분5(IIEF-5)화치료총체만의솔.결과 량조환자균획득수방,평균수방15개월(10-22개월).치료후량조IPSS、QOL평분화총체만의솔비교차이무통계학의의,단A조적Q_(max)고우B조[(20.6±2.8)ml/s비(17.1±3.2)ml/s,P＜0.05],이B조적IIEF-5저우A조[(16.5±4.7)분비(19.3±3.4)분,P＜0.05].결론 대반유LUTS적BPH환자,치료전응중시환자성공능요구화평고,과학선택치료조시.염산탄색라신재개선LUTS적동시가명현개선환자성공능,경뇨도수술수가유효해제방광출구 경조,단가도치발기공능하강.
Objective To improve therapeutic selection of benign prostatic hyperplasia ( BPH) with lower urinary tract symptoms (LUTS). Methods Two hundred and nine BPH patients with LUTS were divided into transurethral resection (group A,115 patients) and tamsulosin (group B,94 patients). The international prostate symptoms score (IPSS),quality of life (QOL),maximal flow rate (Qmax),international index of erectile function 5 (ITEF-5) and satisfactory degree were used for investigating safety and efficacy before and after the treatments. Results Mean follow-up periods were 15 months (ranged 10 to 22 months),all patients were followed up. IPSS,QOL and satisfactory degree between the two groups were no statistically significance after treatment. Qmax of group A was superior to group B [ (20.6 ± 2.8) ml/s vs (17.1 ±3.2) ml/s,P＜0.05],while IIEF-5 of group A was superior to group B [(19.3 ±3.4) scores vs (16.5 ±4.7) scores,P＜ 0.05]. Conclusions Therapeutic selections should be based on complete evaluations of patients symptoms and sexual status. Tamsulosin can improve both of the LUTS and sexual function,while transurethral resection of the prostate can relieve bladder outlet obstruction markedly but decrease patients' erectile function.