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目的:探讨经尿道前列腺剜除术治疗伴尿肌无力(ACD)的前列腺增生症(BPH)的临床疗效。方法:回顾性分析行经尿道前列腺剜除术治疗的36例伴ACD的前列腺增生患者,记录围手术期、术后3个月、6个月临床资料(包括IPSS、Qmax、膀胱剩余尿及留置导尿管情况),对所测指标进行统计学分析。结果:36例患者中,术后3个月24例患者能自行排尿(24/36);术后6个月,33例患者能自行排尿(33/36),另外3例因脑血管意外卧床不能自行排尿,留置膀胱造瘘管。各项统计指标与术前比较均差异有统计学意义(P<0.05),其中IPSS评分术前为(25.7±2.4)分、术后3个月为(11.30±1.30)分、术后6个月为(10.7±4.4)分,较术前均有明显改善;Qmax术前(3.4±2.9)ml/s、术后3个月(15.44±2.98)ml/s、术后6个月(18.44±3.18)ml/s,术后较术前均显著提高;膀胱剩余尿术前(164.56±42.6)ml,术后3个月和6个月均小于50ml,明显减少至正常。结论:经尿道前列腺剜除术治疗BPH伴ACD的疗效确切,术后可以自行排尿,生活质量提高,但仍需要更多的临床经验及更长时间的随访。
Objective: To investigate the clinical efficacy of transurethral resection of prostate for the treatment of benign prostatic hyperplasia (BPH) with urinary muscular weakness (ACD). Methods: Thirty-six patients with benign prostatic hyperplasia (ACD) treated by transurethral resection of the urethra were retrospectively analyzed. The clinical data (including IPSS, Qmax, residual bladder urine and indwelling guideline) were recorded during perioperative period, 3 months and 6 months after operation. Catheterization), the measured indicators for statistical analysis. Results: Of the 36 patients, 24 patients were able to urinate spontaneously (24/36) 3 months after operation. Six patients were able to urinate on their own (33/36) at 6 months and another 3 patients died of cerebrovascular accident Can not urinate, indwelling bladder fistula. There were statistically significant differences between the statistical indicators and the preoperative values (P <0.05), including IPSS score was (25.7 ± 2.4) before surgery and (11.30 ± 1.30) after 3 months and 6 Month (10.7 ± 4.4) points, which were significantly improved compared with those before operation; Qmax preoperatively was 3.4 ± 2.9 ml / s, 3 months postoperatively was 15.44 ± 2.98 ml / s and 6 months postoperatively was 18.44 ± 3.18) ml / s, respectively. The postoperative urinary bladder residual urine volume was significantly higher than that before operation (164.56 ± 42.6) ml, less than 50 ml at 3 months and 6 months postoperatively, and significantly decreased to normal. CONCLUSION: Transurethral resection of the prostate with BPH with ACD has a definite curative effect. After surgery, urinary catheterization can improve urination and quality of life. However, more clinical experience and longer follow-up are still needed.