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目的探讨小体积前列腺增生引起膀胱颈出口梗阻的较理想治疗方法。方法自1996-01~2005-01共收治小体积前列腺增生69例,其中耻骨上经膀胱前列腺摘除27例,单纯经尿道前列腺电切除术(TURP)22例,TURP加膀胱颈内切开术(TUIBN)20例。三组患者年龄、病程、术前前列腺重量及手术切除重量均无明显差异。从国际前列腺症状评分(IPSS)、最大尿流率(Qm ax)及膀胱残余尿量(PVR)三个参数来比较三组治疗的疗效。结果术后各项指标均有改善,分别为开放手术组IPSS由(24.6±3.8)降至(15.1±3.8),Qm ax由(8.2±3.1)m l/s升至(10.5±4.2)m l/s,PVR由(96.0±36.0)m l降至(54.0±27.0)m l。单纯TURP组IPSS由(22.3±5.6)降至(11.7±2.7),Qm ax由(8.5±3.6)m l/s升至(11.4±4.2)m l/s,PVR由(105.0±39.0)m l降至(32.0±14.0)m l。TURP加TUIBN组IPSS由(23.6±5.7)降至(6.4±2.3),Qm ax由(9.1±3.8)m l/s升至(19.5±6.2)m l/s,PVR由(98.0±37.0)m l降至(8.0±5.0)m l。TURP加TUIBN组与另两组比较,术后IPSS、Qm ax及PVR均有极显著性差异(P<0.001)。结论TURP加TUIBN是目前治疗小体积前列腺增生引起膀胱颈出口梗阻较为理想的方法。
Objective To investigate the small volume of benign prostatic hyperplasia caused by bladder outlet obstruction more ideal treatment. Methods From January 1996 to January 2005, 69 cases of small-sized benign prostatic hyperplasia (BPH) were treated, including 27 cases of transurethral resection of prostate, 22 cases of simple transurethral resection of prostate (TURP), TURP plus bladder neck excision TUIBN) 20 cases. Three groups of patients age, duration, preoperative prostate weight and surgical resection weight were no significant difference. The efficacy of the three treatment groups was compared with three parameters, IPSS, Qm ax and residual bladder volume (PVR). Results After operation, the indexes of IPSS were improved in the open surgery group from (24.6 ± 3.8) to (15.1 ± 3.8) and Qm ax from (8.2 ± 3.1) ml / s to (10.5 ± 4.2) ml / s, PVR decreased from (96.0 ± 36.0) ml to (54.0 ± 27.0) ml. The IPSS of pure TURP group decreased from (22.3 ± 5.6) to (11.7 ± 2.7), Qm ax increased from (8.5 ± 3.6) ml / s to (11.4 ± 4.2) ml / (32.0 ± 14.0) ml. The IPSS of TURP plus TUIBN group decreased from (23.6 ± 5.7) to (6.4 ± 2.3), Qm ax increased from (9.1 ± 3.8) ml / s to (19.5 ± 6.2) ml / s, PVR decreased from (98.0 ± 37.0) ml To (8.0 ± 5.0) ml. TURP plus TUIBN group compared with the other two groups, postoperative IPSS, Qm ax and PVR were significantly different (P <0.001). Conclusion TURP plus TUIBN is the ideal method for treating bladder outlet obstruction caused by small volume benign prostatic hyperplasia.