经尿道前列腺等离子双极电切术对BPH患者术后性功能及血清PSA、PGI2水平变化的影响
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摘要
目的:探讨经尿道前列腺等离子双极电切术对良性前列腺增生(BPH)患者术后性功能及血清前列腺特异性抗原(PSA)、前列环素(PGI2)水平变化的影响。方法:选取内江市第一人民医院89例BPH患者,依据手术术式不同分组,对照组44例给予气化电切术治疗,观察组45例给予经尿道前列腺等离子双极电切术治疗,观察比较两组手术情况[尿管留置时间、术中出血量、术后视觉模拟评分(VAS)]及手术前后国际前列腺症状(IPSS)评分、性功能各指标[国际勃起功能指数(IIEF-5)评分、早泄患者性功能-5(CIPE-5)评分]及血清PSA、PGI2水平变化情况,并统计两组并发症发生情况。结果:与对照组相比,观察组尿管留置时间短、术中出血量少、术后VAS评分及术后IPSS评分均较对照组低,差异具有统计学意义(P <0. 05);观察组术后IIEF-5及CIPE-5评分均高于对照组,差异具有统计学意义(P <0. 05);观察组术后血清PSA水平低于对照组,血清PGI2水平高于对照组,差异具有统计学意义(P <0. 05);观察组并发症发生率为4. 44%(2/45),低于对照组20. 45%(9/44),差异具有统计学意义(P <0. 05)。结论:采用经尿道前列腺等离子双极电切术治疗可改善BPH患者术后性功能及血清PSA、PGI2水平,效果显著,并发症发生率低。
Objective: To investigate the effect of transurethral plasma kineticvaporization prostatectomy on postoperative sexual function and serum prostate specific antigen( PSA) and prostacyclin( PGI2) levels in patients with benign prostatic hyperplasia( BPH). Methods: 89 patients with BPH in Neijiang First People's Hospital were selected and divided into control group( n = 44) and observation group( n = 45) according to different surgical procedures. The control group was given electrovaporization,while the observation group was given transurethral plasma kineticvaporization prostatectomy. Surgery condition [catheter retention time,intraoperative blood loss,postoperative visual analogue scale( VAS) ],the International Prostate Symptom( IPSS) score before and after surgery,the indicators of sexual function [International index of erectile function( IIEF-5) score,China index of the sexual function of premature ejaculation patients( CIPE-5) score] and changes in serum PSA,PGI2 levels were observed and compared between the two groups,and the incidence of complications was statistically analyzed. Results: The intraoperative blood loss,catheter retention time and postoperative VAS score in the observation group were lower than those in the control group,with statistically significant difference( P < 0. 05). The IPSS score of the observation group was lower than that of the control group after treatment,with statistically significant difference( P <0. 05). After treatment,the scores of IIEF-5 and CIPE-5 of the observation group were significantly higher than those of the control group,with statistically significant difference( P < 0. 05). The serum PSA level in the observation group was significantly lower than that in the control group,and the level of serum PGI2 was significantly higher than that of the control group,all with statistically significant differences( P < 0. 05). The incidence of complications in the observation group( 4. 44%,2/45) was lower than that in the control group( 20. 45%,9/44),with statistically significant difference( P < 0. 05). Conclusions: Transurethral plasma kineticvaporization prostatectomy can improve the postoperative sexual function and serum PSA and PGI2 levels of patients with BPH,with remarkable effect and low incidence of complications.
Objective: To investigate the effect of transurethral plasma kineticvaporization prostatectomy on postoperative sexual function and serum prostate specific antigen( PSA) and prostacyclin( PGI2) levels in patients with benign prostatic hyperplasia( BPH). Methods: 89 patients with BPH in Neijiang First People's Hospital were selected and divided into control group( n = 44) and observation group( n = 45) according to different surgical procedures. The control group was given electrovaporization,while the observation group was given transurethral plasma kineticvaporization prostatectomy. Surgery condition [catheter retention time,intraoperative blood loss,postoperative visual analogue scale( VAS) ],the International Prostate Symptom( IPSS) score before and after surgery,the indicators of sexual function [International index of erectile function( IIEF-5) score,China index of the sexual function of premature ejaculation patients( CIPE-5) score] and changes in serum PSA,PGI2 levels were observed and compared between the two groups,and the incidence of complications was statistically analyzed. Results: The intraoperative blood loss,catheter retention time and postoperative VAS score in the observation group were lower than those in the control group,with statistically significant difference( P < 0. 05). The IPSS score of the observation group was lower than that of the control group after treatment,with statistically significant difference( P <0. 05). After treatment,the scores of IIEF-5 and CIPE-5 of the observation group were significantly higher than those of the control group,with statistically significant difference( P < 0. 05). The serum PSA level in the observation group was significantly lower than that in the control group,and the level of serum PGI2 was significantly higher than that of the control group,all with statistically significant differences( P < 0. 05). The incidence of complications in the observation group( 4. 44%,2/45) was lower than that in the control group( 20. 45%,9/44),with statistically significant difference( P < 0. 05). Conclusions: Transurethral plasma kineticvaporization prostatectomy can improve the postoperative sexual function and serum PSA and PGI2 levels of patients with BPH,with remarkable effect and low incidence of complications.
引文
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[10]黄明坦,叶泽兵,刘百川,等.经尿道前列腺等离子双极电切治疗高危良性前列腺增生症的临床疗效观察.海南医学,2014,25(4):498-500.
[11] Mulhall JP,Brock GB,Glina S,et al. Impact of baseline total testosterone level on successful treatment of sexual dysfunction in men taking oncedaily tadalafil 5 mg for lower urinary tract symptoms and benign prostatic hyperplasia:an integrated analysis of three randomized controlled trials.The Journal of Sexual Medicine,2016,13(5):843-851.
[12]朱凌峰,谭建明.经尿道双极等离子前列腺剜除术治疗体积大于60ml前列腺增生的疗效分析.中国微创外科杂志,2016,16(5):394-398.
[13]崔杨,郑宗宇,朱德淳,等.尿道前列腺汽化电切术治疗老年男性巨大良性前列腺增生的有效性.中国老年学杂志,2017,37(8):1967-1968.
[14]张菊根,吴振启,郭建明.经尿道双极等离子电切术治疗良性前列腺增生症的临床研究.现代中西医结合杂志,2013,22(6):631-632.
[15]张孝雄,吴健,罗德毅,等.经尿道双极等离子电切术治疗良性前列腺增生的疗效分析.西部医学,2015,27(2):200-202.
[16]杨玉恺,李飞,陆鲲,等.经尿道前列腺电切术与双极等离子前列腺切除术对良性前列腺增生患者性功能影响的对比研究.中国性科学,2015,24(7):5-7.
[17]刘绍虔,米其武,张志刚.经尿道前列腺等离子双极电切术后尿路感染及其危险因素分析.西部医学,2015,27(2):252-254.
[18]徐章寿,邰鹏,李成,等.经尿道等离子双极电切术治疗前列腺增生症的疗效观察与并发症分析.国际泌尿系统杂志,2014,34(5):722-725.
[2]甘露,曾静,黄桂晓,等.经尿道前列腺等离子双极电切术与耻骨上经膀胱前列腺切除术治疗良性前列腺增生的疗效和安全性比较.医学综述,2014,20(5):959-960.
[3]王梦芝.良性前列腺增生症的药物治疗进展.医学综述,2014,16(3):491-493.
[4] Perera M,Roberts MJ,Doi SAR,et al. Prostatic urethral lift improves urinary symptoms and flow while preserving sexual function for men with benign prostatic hyperplasia:a systematic review and meta-analysis. European Urology,2015,67(4):704-713.
[5]刘永胜,王鹏,杜维利. PKRP与TUVP治疗高危良性前列腺增生的安全性比较.现代中西医结合杂志,2014,23(1):71-72.
[6]肖伟,杨科,高智勇,等.经尿道前列腺电切术与经尿道双极等离子电切术治疗良性前列腺增生比较分析及安全性评价.重庆医科大学学报,2014,38(1):76-79.
[7]陈孝平,汪建平.外科学. 8版.北京:人民卫生出版社,2013:571-573.
[8]杜依青,米白冰,王珏,等.经尿道等离子双极电切术与传统单极电切术治疗前列腺增生症比较的Meta分析.现代泌尿外科杂志,2014,19(7):456-461.
[9] Fwu CW,Eggers PW,Kirkali Z,et al. Change insexual function in men with lower urinary tract symptoms/benign prostatic hyperplasia associated with long-term treatment with doxazosin,finasteride and combined therapy. The Journal of Urology,2014,191(6):1828-1834.
[10]黄明坦,叶泽兵,刘百川,等.经尿道前列腺等离子双极电切治疗高危良性前列腺增生症的临床疗效观察.海南医学,2014,25(4):498-500.
[11] Mulhall JP,Brock GB,Glina S,et al. Impact of baseline total testosterone level on successful treatment of sexual dysfunction in men taking oncedaily tadalafil 5 mg for lower urinary tract symptoms and benign prostatic hyperplasia:an integrated analysis of three randomized controlled trials.The Journal of Sexual Medicine,2016,13(5):843-851.
[12]朱凌峰,谭建明.经尿道双极等离子前列腺剜除术治疗体积大于60ml前列腺增生的疗效分析.中国微创外科杂志,2016,16(5):394-398.
[13]崔杨,郑宗宇,朱德淳,等.尿道前列腺汽化电切术治疗老年男性巨大良性前列腺增生的有效性.中国老年学杂志,2017,37(8):1967-1968.
[14]张菊根,吴振启,郭建明.经尿道双极等离子电切术治疗良性前列腺增生症的临床研究.现代中西医结合杂志,2013,22(6):631-632.
[15]张孝雄,吴健,罗德毅,等.经尿道双极等离子电切术治疗良性前列腺增生的疗效分析.西部医学,2015,27(2):200-202.
[16]杨玉恺,李飞,陆鲲,等.经尿道前列腺电切术与双极等离子前列腺切除术对良性前列腺增生患者性功能影响的对比研究.中国性科学,2015,24(7):5-7.
[17]刘绍虔,米其武,张志刚.经尿道前列腺等离子双极电切术后尿路感染及其危险因素分析.西部医学,2015,27(2):252-254.
[18]徐章寿,邰鹏,李成,等.经尿道等离子双极电切术治疗前列腺增生症的疗效观察与并发症分析.国际泌尿系统杂志,2014,34(5):722-725.