CAJ | 학술논문

目的：探讨超声测定膀胱内前列腺突入度（IPP）对前列腺增生（BPH）患者行前列腺电切（TURP）手术效果的预测评估作用。方法136例患者因BPH入院行TURP，经腹超声测量IPP，根据IPP程度将患者分为突入组（IPP＞10mm）66例，对照组（IPP≤10mm）70例，比较2组术前前列腺体积（PV）、前列腺特异性抗原（PSA）差异，统计、分析2组术前和TURP术后6个月国际前列腺症状评分（IPSS）、生活质量评分（QoL）、最大尿流率（Qmax）、残余尿量（PVR）变化；多因素分析IPP与手术效果的相关性。结果两组年龄、术前IPSS、QoL相比无差异（P＞0.05），但突入组PV、PSA、Qmax、PVR与对照组相比有统计学差异（P＜0.05），两组TURP术后随访6个月，突入组 IPSS下降、PVR减少和Qmax提高与对照组相比有统计学差异（P＜0.05）；多因素分析显示IPP程度与TURP术后IPSS下降（OR=2.98，95%=1.05~6.89）、Qmax提高（OR=5.96，95%=2.85~9.55）相关。结论IPP程度可影响BPH患者PVR和Qmax，相对于IPP≤10mm，IPP＞10mm的BPH患者TURP术后IPSS下降、PVR减少和Qmax提高更加明显，IPP程度可预测BPH患者TURP术后IPSS下降、Qmax提高。
목적：탐토초성측정방광내전렬선돌입도（IPP）대전렬선증생（BPH）환자행전렬선전절（TURP）수술효과적예측평고작용。방법136례환자인BPH입원행TURP，경복초성측량IPP，근거IPP정도장환자분위돌입조（IPP＞10mm）66례，대조조（IPP≤10mm）70례，비교2조술전전렬선체적（PV）、전렬선특이성항원（PSA）차이，통계、분석2조술전화TURP술후6개월국제전렬선증상평분（IPSS）、생활질량평분（QoL）、최대뇨류솔（Qmax）、잔여뇨량（PVR）변화；다인소분석IPP여수술효과적상관성。결과량조년령、술전IPSS、QoL상비무차이（P＞0.05），단돌입조PV、PSA、Qmax、PVR여대조조상비유통계학차이（P＜0.05），량조TURP술후수방6개월，돌입조 IPSS하강、PVR감소화Qmax제고여대조조상비유통계학차이（P＜0.05）；다인소분석현시IPP정도여TURP술후IPSS하강（OR=2.98，95%=1.05~6.89）、Qmax제고（OR=5.96，95%=2.85~9.55）상관。결론IPP정도가영향BPH환자PVR화Qmax，상대우IPP≤10mm，IPP＞10mm적BPH환자TURP술후IPSS하강、PVR감소화Qmax제고경가명현，IPP정도가예측BPH환자TURP술후IPSS하강、Qmax제고。
Objective To evaluate the clinical value of intravesical prostatic protrusion (IPP) for predicting postoperative outcomes of transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia(BPH). Methods Total of 136 BPH patients treated with TURP, who were followed-up for 6 months, were divided into two groups on the basis of the degree of IPP: the IPP group (IPP>10 mm, n=66) and the control group (IPP≤10mm, n=70). Clinical parameters of patients such as the International Prostate Symptom Score (IPSS), quality-of-life (QoL) score, maximum urinary flow rate (Qmax), and postvoid residual urine (PVR) of preoperation and postoperation were collected and analyzed. Multivariate logistic regression analysis was performed to identify whether IPP could predict surgical outcomes of TURP. Results There were no significant difference in preoperative parameters between the two groups except for prostate volume, PSA, Qmax and PVR . Levels of postoperative parameters such as IPSS, Qmax and PVR were higher in the IPP group than that in the control group. QoL score were not significantly different between the two groups. Multivariate logistic regression analysis revealed that the odds ratios (95% confidence interval) of decreased IPSS and increased Qmax in the significant IPP group were 2.98 (95%=1.05~6.89) and 5.96(95%=2.85~9.55), respectively (P=0.035 and 0.028, respectively).Conclusion The degree of IPP can significantly affect prostate volume, IPSS , PVR and Qmax. IPP may be a factor for predicting better postoperative outcomes of IPSS and Qmax.