中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2011年
32期
2239-2242
,共4页
杨柏帅%叶定伟%彭江燕%姚旭东%张世林%戴波%张海梁%沈益君%朱耀%朱一平%施国海
楊柏帥%葉定偉%彭江燕%姚旭東%張世林%戴波%張海樑%瀋益君%硃耀%硃一平%施國海
양백수%협정위%팽강연%요욱동%장세림%대파%장해량%침익군%주요%주일평%시국해
前列腺肿瘤%前列腺切除术%尿控
前列腺腫瘤%前列腺切除術%尿控
전렬선종류%전렬선절제술%뇨공
Prostatic neoplasms%Prostatectomy%Urinary continence
目的 从客观临床特征、手术技巧、术后功能锻炼等方面,了解前列腺癌根治术人群中经耻骨后前列腺癌根治术后与尿控相关的影响因素.方法 回顾性分析前列腺癌根治术并完整资料的患者263例,随访术后尿控情况,记录相关临床特征,对与尿控相关的因素进行统计学分析.结果 经耻骨后前列腺癌根治术中最大限度保留尿道外括约肌,保留神经血管束,术后早期功能锻炼等积极处理对于尿控有显著帮助.术后4周尿控率为14.8%,术后16周尿控率94.7%,术后4周至术后12周,患者尿控恢复最快,对术后尿控具有明显不良反应的因素有:年龄上升(P=0.015)、术中输血(P=0.017)和既往经尿道前列腺电切术(TURP)(P=0.006),而术前新辅助内分泌治疗对尿控则有帮助(P=0.005).结论 患者手术时年龄、术中输血、既往TURP、术前新辅助内分泌治疗是根治术后尿控的重要影响因素,前三者是独立的预后因素,而后者通过影响功能尿道长度而对术后尿控产生作用.
目的 從客觀臨床特徵、手術技巧、術後功能鍛煉等方麵,瞭解前列腺癌根治術人群中經恥骨後前列腺癌根治術後與尿控相關的影響因素.方法 迴顧性分析前列腺癌根治術併完整資料的患者263例,隨訪術後尿控情況,記錄相關臨床特徵,對與尿控相關的因素進行統計學分析.結果 經恥骨後前列腺癌根治術中最大限度保留尿道外括約肌,保留神經血管束,術後早期功能鍛煉等積極處理對于尿控有顯著幫助.術後4週尿控率為14.8%,術後16週尿控率94.7%,術後4週至術後12週,患者尿控恢複最快,對術後尿控具有明顯不良反應的因素有:年齡上升(P=0.015)、術中輸血(P=0.017)和既往經尿道前列腺電切術(TURP)(P=0.006),而術前新輔助內分泌治療對尿控則有幫助(P=0.005).結論 患者手術時年齡、術中輸血、既往TURP、術前新輔助內分泌治療是根治術後尿控的重要影響因素,前三者是獨立的預後因素,而後者通過影響功能尿道長度而對術後尿控產生作用.
목적 종객관림상특정、수술기교、술후공능단련등방면,료해전렬선암근치술인군중경치골후전렬선암근치술후여뇨공상관적영향인소.방법 회고성분석전렬선암근치술병완정자료적환자263례,수방술후뇨공정황,기록상관림상특정,대여뇨공상관적인소진행통계학분석.결과 경치골후전렬선암근치술중최대한도보류뇨도외괄약기,보류신경혈관속,술후조기공능단련등적겁처리대우뇨공유현저방조.술후4주뇨공솔위14.8%,술후16주뇨공솔94.7%,술후4주지술후12주,환자뇨공회복최쾌,대술후뇨공구유명현불량반응적인소유:년령상승(P=0.015)、술중수혈(P=0.017)화기왕경뇨도전렬선전절술(TURP)(P=0.006),이술전신보조내분비치료대뇨공칙유방조(P=0.005).결론 환자수술시년령、술중수혈、기왕TURP、술전신보조내분비치료시근치술후뇨공적중요영향인소,전삼자시독립적예후인소,이후자통과영향공능뇨도장도이대술후뇨공산생작용.
Objective There are many causative factors for the occurrence of post-prostatectomy incontinence.Objective clinical characteristics, surgical techniques and pelvic floor muscle therapy are the most important ones.The present study was to identify the risk factors associated with urinary incontinence after radical retropubic prostatectomy (RRP).Methods A total of 263 patients were recruited for this multivariate analysis.After a close follow-up, a series of pre-, perl- and post-operative factors were recorded and analyzed.Results Urinary continence after radical prostatectomy was 14.8% at 4 weeks and 94.7% at 16 weeks.The most important recovery interval for urinary continence was 4-16 weeks post-operation.Multivariate analysis revealed that age ( P = 0.015 ), blood transfusion ( P = 0.017 ), previous TURP( transurethral resection of the prostate) ( P = 0.006) and neoadjuvant hormonal therapy ( P = 0.005 ) were the important risk factors for urinary incontinence.Conclusion During RRP, optimized preservation of urethral rhabdosphincter length, nerve sparing and early postoperative functional exercises can improve the recovery of urinary continence.Age, blood transfusion and previous TURP are the independent prognostic factors.Neoadjuvant hormonal therapy may improve urinary continence through increasing the preoperative length of membranous urethra.
