现代中西医结合杂志
現代中西醫結閤雜誌
현대중서의결합잡지
Modern Journal of Integrated Traditional Chinese and Western Medicine
2015年
33期
3658-3661
,共4页
良性前列腺增生症%尿道钬激光前列腺剜除术%胰岛素生长因子-1%胰岛素生长因子结合蛋白-3
良性前列腺增生癥%尿道鈥激光前列腺剜除術%胰島素生長因子-1%胰島素生長因子結閤蛋白-3
량성전렬선증생증%뇨도화격광전렬선완제술%이도소생장인자-1%이도소생장인자결합단백-3
benign prostatic hyperplasia%transurethral holmium laser enucleation of the prostate%insulin-like growth fac-tor-1%insulin-like growth factor binding protein 3
目的：观察经尿道钬激光前列腺剜除术（HoLEP）和经尿道前列腺汽化电切术（TUEVP）治疗大体积良性前列腺增生症（BPH）的疗效及对血清前列腺特异性抗原（PSA）、胰岛素生长因子－1（IGF－1）和胰岛素生长因子结合蛋白－3（IGFBP－3）水平的影响。方法根据手术方式不同将133例大体积BPH患者分为2组，观察组85例行HoLEP治疗，对照组48例行TUEVP治疗。观察2组出血量、手术时间、切除质量、膀胱冲洗时间、留置尿管时间、住院时间、并发症发生情况，治疗前后最大尿流率（ Qmax ）、国际前列腺症状评分（ IPSS）、生活质量指数（ QOL）、残余尿量（ RUV）及血清PSA、IGF－1、IGFBP－3水平。结果观察组的出血量、手术时间、切除质量、膀胱冲洗时间、留置尿管时间和住院时间均明显少于或者短于对照组（P均＜0．05），2组并发症发生率比较差异无统计学意义（P＞0．05）。2组治疗后IPSS、QOL、RUV及血清PSA、IGF－1、IGFBP－3水平均较治疗前明显降低（P均＜0．05），Qmax较治疗前明显升高（P均＜0．05），且观察组血清PSA、IGF－1和IGFBP－3水平较对照组降低更为明显（P均＜0．05），2组IPSS、QOL、RUV比较差异均无统计学意义（P均＞0．05）。结论 HoLEP治疗BPH疗效显著，能够明显提高患者术后生活质量，具有术中出血少、手术时间短、创伤小的优点，且可降低血清PSA、IGF－1和IGFBP－3水平。
目的：觀察經尿道鈥激光前列腺剜除術（HoLEP）和經尿道前列腺汽化電切術（TUEVP）治療大體積良性前列腺增生癥（BPH）的療效及對血清前列腺特異性抗原（PSA）、胰島素生長因子－1（IGF－1）和胰島素生長因子結閤蛋白－3（IGFBP－3）水平的影響。方法根據手術方式不同將133例大體積BPH患者分為2組，觀察組85例行HoLEP治療，對照組48例行TUEVP治療。觀察2組齣血量、手術時間、切除質量、膀胱遲洗時間、留置尿管時間、住院時間、併髮癥髮生情況，治療前後最大尿流率（ Qmax ）、國際前列腺癥狀評分（ IPSS）、生活質量指數（ QOL）、殘餘尿量（ RUV）及血清PSA、IGF－1、IGFBP－3水平。結果觀察組的齣血量、手術時間、切除質量、膀胱遲洗時間、留置尿管時間和住院時間均明顯少于或者短于對照組（P均＜0．05），2組併髮癥髮生率比較差異無統計學意義（P＞0．05）。2組治療後IPSS、QOL、RUV及血清PSA、IGF－1、IGFBP－3水平均較治療前明顯降低（P均＜0．05），Qmax較治療前明顯升高（P均＜0．05），且觀察組血清PSA、IGF－1和IGFBP－3水平較對照組降低更為明顯（P均＜0．05），2組IPSS、QOL、RUV比較差異均無統計學意義（P均＞0．05）。結論 HoLEP治療BPH療效顯著，能夠明顯提高患者術後生活質量，具有術中齣血少、手術時間短、創傷小的優點，且可降低血清PSA、IGF－1和IGFBP－3水平。
목적：관찰경뇨도화격광전렬선완제술（HoLEP）화경뇨도전렬선기화전절술（TUEVP）치료대체적량성전렬선증생증（BPH）적료효급대혈청전렬선특이성항원（PSA）、이도소생장인자－1（IGF－1）화이도소생장인자결합단백－3（IGFBP－3）수평적영향。방법근거수술방식불동장133례대체적BPH환자분위2조，관찰조85례행HoLEP치료，대조조48례행TUEVP치료。관찰2조출혈량、수술시간、절제질량、방광충세시간、류치뇨관시간、주원시간、병발증발생정황，치료전후최대뇨류솔（ Qmax ）、국제전렬선증상평분（ IPSS）、생활질량지수（ QOL）、잔여뇨량（ RUV）급혈청PSA、IGF－1、IGFBP－3수평。결과관찰조적출혈량、수술시간、절제질량、방광충세시간、류치뇨관시간화주원시간균명현소우혹자단우대조조（P균＜0．05），2조병발증발생솔비교차이무통계학의의（P＞0．05）。2조치료후IPSS、QOL、RUV급혈청PSA、IGF－1、IGFBP－3수평균교치료전명현강저（P균＜0．05），Qmax교치료전명현승고（P균＜0．05），차관찰조혈청PSA、IGF－1화IGFBP－3수평교대조조강저경위명현（P균＜0．05），2조IPSS、QOL、RUV비교차이균무통계학의의（P균＞0．05）。결론 HoLEP치료BPH료효현저，능구명현제고환자술후생활질량，구유술중출혈소、수술시간단、창상소적우점，차가강저혈청PSA、IGF－1화IGFBP－3수평。
Objective It is to observe the curative effect of transurethral holmium laser enucleation of the prostate ( Ho-LEP) and transurethral electro-vaporization resection of the prostate ( TUEVP) in treatment of large-volume benign prostatic hyperplasia (BPH) and their impact on the levels of prostate specific antigen (PSA), insulin growth factor-1 (IGF-1) and insulin-like growth factor binding protein -3 ( IGFBP-3 ) .Methods 233 patients with large-volume BPH were divided into observation group (85 cases) and control group (48 cases) according to the surgical procedure , the patients were treated with HoLEP in the observation group and TUEVP in the control group .The blood loss, surgical time, excision quality, bladder irri-gation time, indwelling catheter time , hospital stay and incidence of complication were observed in two groups , and the levels of maximum urinary flow rate (Qmax), prostate symptom score (IPSS), quality of life Index (QOL), residual urine (RUV), PSA, IGF-1 and IGFBP-3 were also observed before and after treatment in two groups .Results After treatment, the blood loss, operation time, resection quality, bladder irrigation time, indwelling catheter time and hospital stay were significantly less or shorter in the observation group than those in the control group (all P<0.05), but there was not statistically significant difference in the incidence of complication between two groups (P>0.05).After treatment, the levels of IPSS, QOL, RUV, PSA and IGF-1 were significantly lower in two groups than those before treatment (all P<0.05), and the levels of Qmax sig-nificantly increased in two groups compared with those before treatment (all P<0.05), while the levels of PSA, IGF-1 and IGFBP-3 in observation group were significantly reduced compared with the control group (all P<0.01), there was no sig-nificant difference in the levels of IPSS, QOL and RUV between the two groups (all P>0.05).Conclusion The curative effect of HoLEP in treatment of large-volume BPH were obvious , it can significantly improve the QOL after surgery , with less bleeding, shorter operative time, less trauma, and lower levels of PSA, IGF-1 and IGFBP-3 after treatment.
