CAJ | 학술논문

目的：探讨经尿道前列腺电汽化术(TUVP)联合经尿道前列腺电切术(TURP)治疗高危前列腺增生的临床疗效及安全性。方法根据入院先后顺序及患者意愿,将93例高危前列腺增生患者分为 TUVP+TURP组(n=47)和 TURP 组(n =46)。两组术前均积极治疗合并症及基础疾病,TURP 组行 TURP 治疗,TUVP +TURP 组行 TUVP 联合 TURP 治疗。比较两组术前及术后1年的最大尿流率(Qmax)、膀胱残余尿量(RUV)、国际前列腺症状评分(IPSS)及生活质量(QOL)评分,并观察术后不良反应的发生情况。结果两组术后并发症主要包括经尿道电切综合征(TUPS)、继发血尿、尿潴留、暂时性尿失禁和尿路刺激症,TUVP+TURP 组并发症总发生率明显低于 TURP 组,差异有统计学意义(P <0.05)。术后1年,两组 Qmax 均较术前明显增加,而 RUV、IPSS 及QOL 评分明显降低,差异有统计学意义(P <0.01)；组间各指标比较,差异无统计学意义(P >0.05)。结论TUVP 联合 TURP治疗高危前列腺增生可充分发挥两种术式的优点,减少术后并发症的发生,且安全性较高,值得临床推广应用。
목적：탐토경뇨도전렬선전기화술(TUVP)연합경뇨도전렬선전절술(TURP)치료고위전렬선증생적림상료효급안전성。방법근거입원선후순서급환자의원,장93례고위전렬선증생환자분위 TUVP+TURP조(n=47)화 TURP 조(n =46)。량조술전균적겁치료합병증급기출질병,TURP 조행 TURP 치료,TUVP +TURP 조행 TUVP 연합 TURP 치료。비교량조술전급술후1년적최대뇨류솔(Qmax)、방광잔여뇨량(RUV)、국제전렬선증상평분(IPSS)급생활질량(QOL)평분,병관찰술후불량반응적발생정황。결과량조술후병발증주요포괄경뇨도전절종합정(TUPS)、계발혈뇨、뇨저류、잠시성뇨실금화뇨로자격증,TUVP+TURP 조병발증총발생솔명현저우 TURP 조,차이유통계학의의(P <0.05)。술후1년,량조 Qmax 균교술전명현증가,이 RUV、IPSS 급QOL 평분명현강저,차이유통계학의의(P <0.01)；조간각지표비교,차이무통계학의의(P >0.05)。결론TUVP 연합 TURP치료고위전렬선증생가충분발휘량충술식적우점,감소술후병발증적발생,차안전성교고,치득림상추엄응용。
Objective To explore the clinical efficacy and safety of transurethral vaporization of prostate (TUVP ) combined with transurethral remove of prostate (TURP ) in the treatment of high-risk prostatic hyperplasia.Methods According to the sequences of hospitalization and patients′intentions,93 patients with high-risk prostatic hyperplasia were divided into TUVP+TURP group (47 cases)and TURP group (46 cases).Before operation,complications and basic disease in both groups were positively treated,on which basis TURP group was treated with TURP while TUVP+ TURP group with TUVP combined with TURP.The maximum urinary flow rate (Qmax),residual urine volume (RUV),international prostate symptom score (IPSS)and quality of life (QOL)before and 1 year after operation were compared between two groups,and the conditions of postoperative adverse responses were recorded. Results Postoperative complications in both groups included transurethral prostate resection syndrome (TUPS ), secondary blood urine, postoperative urinary retention, temporary incontinence and urinary tract irritation,whose rate was evidently higher in TUVP+TURP group than in TURP group,and the difference was statistically significant (P < 0.05 ).One year after operation,Qmax increased markedly in both groups,whereas RUV,IPSS and QOL scores decreased apparently than those before operation (P <0.01 ),but there was no statistically significant difference between two groups (P > 0.05 ).Conclusion TUVP combined with TURP can fully exploit their advantages,reduce the rate of complications,and is safer in treating patients with high-risk prostatic hyperplasia.