经尿道前列腺等离子体摘除治疗良性前列腺增生合并膀胱逼尿肌收缩不足的研究

Yong Li, Zhongjun Chen
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摘要

目的:探讨经尿道前列腺血浆去核术治疗前列腺增生伴膀胱逼尿肌收缩力不足的临床疗效。方法:回顾性分析我科2021年7月至2022年7月收治的68例良性前列腺增生伴逼尿肌收缩力减退患者的临床资料。以上患者均符合良性前列腺增生的诊断,不包括前列腺癌和尿道狭窄。尿动力学显示膀胱逼尿肌收缩力下降,手术设备采用奥林巴斯双极等离子切除设备方法。将上述患者分为两组:实验组34例经尿道前列腺等离子切除,对照组34例经尿道前列腺等离子切除。评价两组患者术前临床基线水平及术后观察指标,比较两组间的统计学差异。结果:两组患者均顺利完成手术,术中无直肠、膀胱穿孔等严重并发症,出血少。经尿道血浆去核前列腺切除术患者术后生活质量、IPSS、Qmax、残尿量均较术前显著改善(P < 0.05)。结论:经尿道前列腺切除术治疗前列腺增生合并逼尿肌收缩力减弱有较好的疗效和安全性。与传统电切手术相比,其疗效更为显著。在手术主要并发症方面,虽然前列腺摘除术后出现暂时性尿失禁的患者略多,但与电切术后相比无统计学差异,均可在短期内恢复正常。
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Study on the Treatment of Benign Prostate Hyperplasia Combined with Underactive Bladder Detrusor Contraction by Transurethral Plasma Enucleation of the Prostate
Objective: Exploring the clinical efficacy of transurethral plasma enucleation of the prostate in the treatment of benign prostatic hyperplasia with underactive bladder detrusor contractility. Methods: Retrospective analysis of the clinical data of 68 patients with benign prostatic hyperplasia and underactive detrusor muscle contractility treated by our department from July 2021 to July 2022. The above patients all met the diagnosis of benign prostatic hyperplasia, excluding prostate cancer and urethral stricture. Urodynamics showed a decrease in the contractile force of the bladder detrusor muscle, and the surgical equipment used Olympus bipolar plasma resection equipment method. Divide the above patients into two groups: the experimental group of 34 patients who underwent transurethral plasma enucleation of the prostate and the control group of 34 patients who underwent transurethral plasma resection of the prostate. Evaluate the preoperative clinical baseline level and postoperative observation indicators of the two groups of patients, and compare the statistical differences between the two groups. Results: Both groups of patients successfully completed the surgery, and there were no serious complications such as rectal or bladder perforation during the surgery, with less bleeding. The postoperative QOL, IPSS, Qmax, and residual urine volume of patients undergoing transurethral plasma enucleation and resection of the prostate were significantly improved compared to those before surgery (P 0.05). Conclusion: Transurethral enucleation of the prostate has good efficacy and safety in the treatment of benign prostatic hyperplasia combined with weakened detrusor muscle contractility. Compared with traditional electric resection surgery, the efficacy is more significant. In terms of the main complications of the surgery, although there are slightly more patients with temporary urinary incontinence after prostate enucleation, there is no statistically significant difference compared to after electric resection, and they can recover to normal in the short term.
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