经尿道前列腺剜除术中预先精准离断前列腺尖部尿道黏膜方法对患者术后尿控的影响

摘要
图/表
参考文献(18)
相关文章 (15)

全文: PDF (0 KB) HTML (37 KB)
输出: BibTeX | EndNote (RIS)

摘要目的观察经尿道前列腺剜除术中预先精准离断前列腺尖部尿道黏膜方法对患者术后尿控的影响。方法选取2019 年1 月至2020 年6 月在井冈山大学附属医院手术治疗的80 例良性前列腺增生患者，采用随机数字表法分为实验组（40 例）和对照组（40 例）。对照组在前列腺解剖性剜除之后将前列腺尖部尿道黏膜集中到12 点后离断，实验组在剜除前预先精准离断前列腺尖部尿道黏膜，之后将前列腺解剖性剜除。比较两组的术后尿失禁发生率、尿控恢复时间、围术期（总手术时间、腺体剥离时间、术中出血量、膀胱冲洗时间、尿管留置时间、术后住院时间）指标及随访效果。结果实验组患者术后的尿失禁发生率低于对照组，差异有统计学意义（P＜0.05）；实验组患者的尿控恢复时间短于对照组，差异有统计学意义（P＜0.05）；两组患者的围术期指标（总手术时间、腺体剥离时间、术中出血量、膀胱冲洗时间、尿管留置时间、术后住院时间）和术后国际前列腺症状评分（IPSS）、生活质量（QOL）评分、最大尿流率（Qmax）、残余尿量（PVR）疗效指标比较，差异无统计学意义（P＞0.05）。结论经尿道前列腺剜除术中预先精准离断前列腺尖部尿道尿膜方法可降低尿失禁发生率，缩短尿控恢复时间。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	曾宪有
	李秋水
	肖文兴▲

关键词 ：良性前列腺增生, 经尿道前列腺剜除术, 尿道黏膜, 尿失禁

Abstract： Objective To observe the influence of precision-precise dissection of urethral mucosa at prostatic apex during transurethral enucleation on postoperative urinary control in patients. Methods A total of 80 cases of benign prostate hyperplasia in Affiliated Hospital of Jinggangshan University were selected and randomly divided into the experimental group (40 cases) and the control group (40 cases) according to random number table method. In the control group, the urethral mucosa in the apex of the prostate was concentrated to 12 o′clock and then dissected after anatomic enucleation of the prostate. In the experimental group, the urethral mucosa at the apex of the prostate was accurately dissected before enucleation, and then the prostate was anatomically enucleated. The incidence of postoperative urinary incontinence, recovery time of urinary control, perioperative period indexes such as total operative time, time of gland dissection, intraoperative blood loss, bladder irrigation time, catheter indwelling time, postoperative hospitalization time and follow-up results were compared between the two groups. Results The incidence of urinary incontinence in the experimental group was lower than that in the control group, the difference was statistically significant (P<0.05). The recovery time of urinary control in the experimental group was shorter than that in the control group, the difference was statistically significant (P<0.05). There were no significant differences in the indexes of perioperative period indexes such as the total operative time, dissection time, intraoperative blood loss, bladder irrigation time, catheter indwelling time, postoperative hospitalization time and postoperative follow-up efficacy of International Prostate Symptom Scale(IPSS), the score of quality of life (QOL), Qmax, postvoid residual (PVR) between the two groups (P>0.05). Conclusion Precise separation of the urethral membrane of the apex of the prostate during transurethral enucleation of the prostate can reduce the incidence of urinary incontinence and shorten the recovery time of urinary control.

Key words： Benign prostate hyperplasia Transurethral enucleation of the prostate Urethral mucosa Urinary incontinence

基金资助:江西省吉安市科技计划项目（吉市科计字〔2019〕8 号-37）

通讯作者: 肖文兴（1966-），男，江西吉安人，主任医师，主要从事泌尿外科临床工作

作者简介: 曾宪有（1984-），男，江西吉安人，硕士，主要从事泌尿外科临床工作及研究

引用本文:

曾宪有;李秋水;肖文兴▲. 经尿道前列腺剜除术中预先精准离断前列腺尖部尿道黏膜方法对患者术后尿控的影响[J]. 中国当代医药, 2021, 28(34): 98-101.
ZENG Xian-you; LI Qiu-shui; XIAO Wen-xing▲. Influence of precision-precise dissection of urethral mucosa at prostatic apex during transurethral enucleation of prostate on postoperative urinary control in patients. 中国当代医药, 2021, 28(34): 98-101.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I34/98

[5]	刘俊峰，刘春晓，谭朝晖，等.经尿道双极等离子前列腺剜除术与电切术后尿失禁发生率的随机对照研究[J].中华男科学杂志，2014，20（2）：165-168.
[6]	那彦群，叶章群，孙颖浩，等.中国泌尿外科疾病诊断治疗指南（2014 版）[M].北京：人民卫生出版社，2014：245-247.
[9]	Herrmann TR.Enucleation is enucleation is enucleation is enucleation[J].World J Urol，2016，34（10）：1353-1355.
[10]	胡永涛，邹志辉，梁朝朝.前列腺增生外科治疗新进展[J].中华腔镜泌尿外科杂志（电子版），2021，15（1）：84-88.
[13]	程洪林，郭闯，李旭明，等.剜除术与电切术治疗超大前列腺增生的临床疗效分析[J].重庆医学，2017，46（11）：1497-1499.
[14]	黄应龙，王金明，丁明霞，等.主动保留尿控结构的HoLEP和TUPKEP 疗效对比分析[J].临床泌尿外科杂志，2018，33（9）：687-692.
[18]	吴进锋，魏永宝，林乐，等.经尿道钬激光前列腺剜除术的技术要点和尿道黏膜保留的策略[J].现代泌尿外科杂志，2020，25（4）：289-292.
[1]	Liu X，Huang G，Chen P，et al.Comparative effects of Yi Jin Jing versus Tai Chi exercise training on benign prostatic hyperplasia-related outcomes in older adults：study protocol for a randomized controlled trial[J].Trials，2016，17（1）：319.
[2]	Hirasawa Y，Kato Y，Fujita K.Transurethral enucleation with bipolar for benign prostatic hyperplasia：2-year outcomes and the learning curve of a single surgeon′s experience of 603 consecutive patients[J].J Endourol，2017，31（7）：679-685.
[3]	Chen YB，Chen Q，Wang Z，et al.A prospective，randomized clinical trial comparing plasmakinetic resection of the prostate with holmium laser enucleation of the prostate based on a 2-year followup[J].J Urol，2013，189（1）：217-222.
[4]	Anan G，Kaiho Y，Iwamura H，et al.Preoperative pelvic floor muscle exercise for early continence after holmium laser enucleation of the prostate：a randomized controlled study[J].BMC Urol，2020，20（1）：3.
[7]	Yoo S，Park J，Cho SY，et al.Usefulness of the frequencyvolume chart over the International Prostate Symptom Score in patients with benign prostatic hyperplasia in view of global polyuria[J].PLoS One，2018，13（7）：e0197818.
[8]	MP，García R，Araya AX.Fragilidad y su correlación con calidad de vida y utilización de los servicios de salud en personas mayores que viven en la comunidad [Quality of life among frail older people][J].Rev Med Chil，2019，147（7）：870-876.
[11]	Montorsi F，Naspro R，Salonia A，et al.Holmium laser enucleation versus transurethral resection of the prostate：results from a 2-center，prospective，randomized trial in patients with obstructive benign prostatic hyperplasia [J].J Urol，2008，179（5）：S87-S90.
[12]	Wang H，Xiao X，Lu J，et al.Factors associated with clinical out-come in 25 patients with avian influenza A （H7N9）infection in Guangzhou，China[J].BMC Infect Dis，2016，16（1）：534.
[15]	Nam JK，Kim HW，Lee DH，et al.Risk factors for transient urinary incontinence after holmium laser enucleation of the prostate[J].World J Mens Health，2015，33（2）：88-94.
[16]	Hirasawa Y，Kato Y，Fujita K.Age and prostate volume are risk factors for transient urinary incontinence after transurethral enucleation with bipolar for benign prostatic hyperplasia[J].Int J Urol，2018，25（1）：76-80.
[17]	吴进锋，张延榕，李涛，等.“完整保留前列腺尖部尿道黏膜”的经尿道钬激光前列腺剜除术[A]//中国中西医结合学会男科专业委员会.首届男性大健康中西医协同创新论坛暨第三届全国中西医结合男科青年学术论坛论文集[C].中国中西医结合学会男科专业委员会，中国中西医结合学会，2019：2.