α受体阻滞剂联合PKRP术对前列腺增生患者尿道功能与生活质量的影响
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摘要
目的:探讨α受体阻滞剂联合经尿道双极等离子电切术(PKRP)对前列腺增生患者尿道功能与生活质量的影响。方法:选择2014年4月至2015年3月西安医学高等专科学校附属医院泌尿科诊治的108例良性前列腺增生患者为研究对象,根据入院时间先后顺序采用单双号方法将其分为观察组和对照组,每组54例患者。两组患者均择期行PKRP术,观察组患者术后联合应用α受体阻滞剂治疗。比较两组患者尿道功能、性功能、生活质量等指标。结果:术后6个月,观察组患者最大尿道关闭压(MUCP)、最大尿流率(Qmax)明显高于对照组患者,残余尿量(RU)、国际前列腺症状评分(IPSS)明显低于对照组患者(t=5. 282,8. 055,7. 922,8. 631,P <0. 05);精液精浆α-葡萄糖苷酶(α-Glu)、国际勃起功能指数-5 (IIEF-5)评分明显高于对照组患者,精浆酸性磷酸酶(ACP)含量明显低于对照组患者(t=4. 112,2. 777,4. 134,P <0. 05);疾病维度、生理维度、社会维度、心理维度、满意度维度等评分均明显高于对照组患者(t=6. 280,4. 880,4. 369,5. 966,4. 916,P <0. 05)。结论:α受体阻滞剂联合PKRP术有助于提高前列腺增生患者生活质量,可能与改善尿道功能和性功能有关。
Objective: To study the impact of α-receptor blockers combined with transurethral plasmakinetic prostatectomy( PKRP) on the urethral function and life quality of patients with benign prostate hyperplasia( BPH).Methods: 108 patients with BPH from April 2014 to March 2015 were divided into observation group and control group according to the order of admission,each of 54 cases. All the patients underwent PKRP surgery,on which basis the observation group received α-receptor blockers therapy. The urinary function,sexual function and life quality was compared between the two groups. Results: At 6 months after surgery,the Maximum Urethral Closure Pressure( MUCP) and Qmax in the observation group were significantly higher than those in the control group,while residual urine volume( RU) and international prostate symptom score( IPSS) were significantly lower than those of control group( t = 5. 282,8. 055,7. 922,8. 631,P < 0. 05). Semen α-Glu and IIEF-5 in the observation group were significantly higher than those in the control group,while semen ACP was significantly lower than that in the control group( t = 4. 112,2. 777,4. 134,P < 0. 05). The scores of disease dimension,physical dimension,social dimension,psychological dimension and satisfaction dimension were significantly higher than those in the control group( t= 6. 280,4. 880,4. 369,5. 966,4. 916,P < 0. 05). Conclusions: α-receptor blockers combined with PKRP is conductive to improving the life quality of patients with BPH,which may be related to the improvement in urinary function and sexual function.
Objective: To study the impact of α-receptor blockers combined with transurethral plasmakinetic prostatectomy( PKRP) on the urethral function and life quality of patients with benign prostate hyperplasia( BPH).Methods: 108 patients with BPH from April 2014 to March 2015 were divided into observation group and control group according to the order of admission,each of 54 cases. All the patients underwent PKRP surgery,on which basis the observation group received α-receptor blockers therapy. The urinary function,sexual function and life quality was compared between the two groups. Results: At 6 months after surgery,the Maximum Urethral Closure Pressure( MUCP) and Qmax in the observation group were significantly higher than those in the control group,while residual urine volume( RU) and international prostate symptom score( IPSS) were significantly lower than those of control group( t = 5. 282,8. 055,7. 922,8. 631,P < 0. 05). Semen α-Glu and IIEF-5 in the observation group were significantly higher than those in the control group,while semen ACP was significantly lower than that in the control group( t = 4. 112,2. 777,4. 134,P < 0. 05). The scores of disease dimension,physical dimension,social dimension,psychological dimension and satisfaction dimension were significantly higher than those in the control group( t= 6. 280,4. 880,4. 369,5. 966,4. 916,P < 0. 05). Conclusions: α-receptor blockers combined with PKRP is conductive to improving the life quality of patients with BPH,which may be related to the improvement in urinary function and sexual function.
引文
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[13]祝存海,叶昶,王进恩,等.t PSA和c PSA联合检测在前列腺癌诊断中的作用.海南医学院学报,2013,19(3):390-392.
[14]Araujo CL,Quintero IB,Kipar A,et al.Prostatic acid phosphatase is the main acid phosphatase with 5'-ectonucleotidase activity in the male mouse saliva and regulates salivation.Am J Physiol Cell Physiol,2014,306(11):C1017-1027.
[15]胡雷,傅全胜,陈栋,等.选择性α受体阻滞剂治疗良性前列腺增生症下尿路症状对男性射精功能影响的Meta分析.中山大学学报(医学科学版),2014,35(6):941-949.
[16]Chughtai B,Thomas D,Kaplan S.α-blockers,5-α-reductase inhibitors,acetylcholine,β3 agonists,and phosphodiesterase-5s in medical management of lower urinary tract symptoms/benign prostatic hyperplasia:How much do the different formulations actually matter in the classes?Urol Clin North Am,2016,43(3):351-356.
[17]刘卫华,姜书传.α受体阻滞剂联合手术治疗前列腺增生继发间质性膀胱炎的疗效分析.职业与健康,2015,31(4):571-573,576.
[2]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.中华男科学杂志,2014,20(2):165-168.
[3]胡志元,孙秀艳,孙博,等.百乐眠胶囊联合α-受体阻滞剂治疗良性前列腺增生症引起的夜尿症.现代生物医学进展,2014,14(28):5558-5561.
[4]Litwin MS,Mc Naughton-Collins M,Fowler FJ Jr,et al.The national institutes of health chronic prostatitis symptom index:Development and validation of a new outcome measure.Chronic Prostatitis Collaborative Research Network.J Urol,1999,162(2):369-375.
[5]史静铮,孙振球,蔡太生.良性前列腺增生症患者生活质量量表的编制与应用-量表编制与条目筛选.中国卫生统计,2003,20(3):158-161.
[6]Bruke JP,Rhodes T,Jacobson DJ.Association of anthropometric measures with the presence and progression of benign prostatic hyperplasial.American Journal of Epidemiology,2006,164(1):41-46.
[7]Kaplan SA.Re:Comparison of the thermal and histopathological effects of bipolar and monopolar electrosurgical resection of the prostate in a canine model.J Urol,2011,185(5):1979-1980.
[8]刘文才.经尿道前列腺等离子双极电切术与常规电切术治疗良性前列腺增生症疗效比较.海南医学院学报,2011,17(11):1519-1521.
[9]韩雨,曹延炜,于芹超,等.不同α受体阻滞剂联合M受体阻滞剂治疗伴有下尿路症状的前列腺增生的疗效比较.现代泌尿外科杂志,2014,19(5):311-314.
[10]郑鸣,曾铭强,陈金洋,等.盐酸特拉唑嗪与PKRP联合治疗前列腺增生合并高血压的临床研究.现代泌尿外科杂志,2012,17(3):303-305.
[11]祝凌飞.特拉唑嗪治疗良性前列腺增生疗效的Meta分析.中国药房,2013,24(24):2279-2282.
[12]宋培栋.盐酸特拉唑嗪片联合非那雄胺治疗老年良性前列腺增生症40例.中国老年医学杂志,2012,32(17):3826-3827.
[13]祝存海,叶昶,王进恩,等.t PSA和c PSA联合检测在前列腺癌诊断中的作用.海南医学院学报,2013,19(3):390-392.
[14]Araujo CL,Quintero IB,Kipar A,et al.Prostatic acid phosphatase is the main acid phosphatase with 5'-ectonucleotidase activity in the male mouse saliva and regulates salivation.Am J Physiol Cell Physiol,2014,306(11):C1017-1027.
[15]胡雷,傅全胜,陈栋,等.选择性α受体阻滞剂治疗良性前列腺增生症下尿路症状对男性射精功能影响的Meta分析.中山大学学报(医学科学版),2014,35(6):941-949.
[16]Chughtai B,Thomas D,Kaplan S.α-blockers,5-α-reductase inhibitors,acetylcholine,β3 agonists,and phosphodiesterase-5s in medical management of lower urinary tract symptoms/benign prostatic hyperplasia:How much do the different formulations actually matter in the classes?Urol Clin North Am,2016,43(3):351-356.
[17]刘卫华,姜书传.α受体阻滞剂联合手术治疗前列腺增生继发间质性膀胱炎的疗效分析.职业与健康,2015,31(4):571-573,576.