CAJ | 학술논문

目的：探讨前列腺电切术联合耻骨上膀胱穿刺造瘘引流治疗重度前列腺增生的临床效果。方法选取本院2012年11月~2014年5月收治的33例重度前列腺增生患者作为研究对象。随机分为造瘘组(16例)和非造瘘组(17例)。造瘘组给予尿道前列腺电切术和耻骨上膀胱穿刺造瘘引流术治疗，非造瘘组只进行尿道前列腺电切术而不进行造瘘。比较两组的手术时间、术中出血量、住院时间、IPSS、QOL评分、残余尿量、最大尿流量等。结果造瘘组的手术时间、出院时间显著短于非造瘘组，术中出血量显著少于非造瘘组，切除腺体体积显著大于非造瘘组，差异有统计学意义(P<0.05)。两组术后的IPSS、QOL评分显著低于术前，残余尿量显著少于术前，最大尿流量显著多于术前，差异有统计学意义(P<0.05)。造瘘组术后的IPSS、QOL评分显著低于非造瘘组术后，残余尿量显著少于非造瘘组术后，最大尿流量显著多于非造瘘组术后，差异有统计学意义(P<0.05)。结论前列腺电切术和耻骨上膀胱穿刺造瘘引流治疗重度前列腺增生的效果显著，值得临床推广应用。
목적：탐토전렬선전절술연합치골상방광천자조루인류치료중도전렬선증생적림상효과。방법선취본원2012년11월~2014년5월수치적33례중도전렬선증생환자작위연구대상。수궤분위조루조(16례)화비조루조(17례)。조루조급여뇨도전렬선전절술화치골상방광천자조루인류술치료，비조루조지진행뇨도전렬선전절술이불진행조루。비교량조적수술시간、술중출혈량、주원시간、IPSS、QOL평분、잔여뇨량、최대뇨류량등。결과조루조적수술시간、출원시간현저단우비조루조，술중출혈량현저소우비조루조，절제선체체적현저대우비조루조，차이유통계학의의(P<0.05)。량조술후적IPSS、QOL평분현저저우술전，잔여뇨량현저소우술전，최대뇨류량현저다우술전，차이유통계학의의(P<0.05)。조루조술후적IPSS、QOL평분현저저우비조루조술후，잔여뇨량현저소우비조루조술후，최대뇨류량현저다우비조루조술후，차이유통계학의의(P<0.05)。결론전렬선전절술화치골상방광천자조루인류치료중도전렬선증생적효과현저，치득림상추엄응용。
Objective To explore the clinical effect of transurethral resection of prostate combined with suprapubic puncture cystostomy for drainage in the treatment of severe benign prostatic hyperplasia. Methods 33 cases with severe benign prostatic hyperplasia from November 2012 to May 2014 in our hospital were selected and randomly divided into the fistulization group(n=16) and the non-fistulization group(n=17). The fistulization group was treated with transurethral resection of prostate combined with suprapubic puncture cystostomy for drainage,the non-fistulization group was treated with transurethral resection of prostate.Operative time,intraoperative amount of bleeding,hospitalization time,internation-al prostate symptom score (IPSS),quality of life (QOL),residual urine volume,maximum urine flow in two groups was compared. Results The time of operative time,hospitalization time in the fistulization gorup was shorter than that in the control group,the intraoperative amount of bleeding in the fistulization gorup was less than that in the control group,the removal of the prostate volume significantly greater than the colostomy group,the resected volume of severe benign pro-static hyperplasia in the fistulization gorup was greater than that in the control group,with significant difference(P<0.05). The score of IPSS and QOL in two groups after treatment was lower than that before treatment,the residual urine volume in two groups after treatment was less than that before treatment,the maximum urine flow in two groups after treatment was more than that before treatment,with significant difference (P<0.05).The score of IPSS and QOL in the fistulization group after treatment was lower than that in the non-fistulization group after treatment,the residual urine volume in the fistulization group after treatment was less than that in the non-fistulization group after treatment,the maximum urine flow in the fistulization group after treatment was more than that in the non-fistulization group after treatment,with sig-nificant difference (P<0.05). Conclusion The effect of transurethral resection of prostate combined with suprapubic puncture cystostomy is significant,it is worthy of clinical promotion and application.