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目的:评估切除的前列腺组织的体积(RPV)对经尿道前列腺电切术(TURP)术后国际前列腺症状评分(IPSS)、生活质量(Qo L)评分及排尿功能的影响。方法:2012年1月至2014年12月接受TURP手术、术后病理证实为BPH的患者82例,分析术前及术后3个月患者IPSS、Qo L、残余尿量(PVR)以及最大尿流率(Qmax)的变化。术前通过超声测定前列腺总体积(TPV)和移行带体积(TZV),分析RPV以及RPV/TPV和RPV/TZV对TURP效果的影响。结果:TURP术后3个月,Qmax平均增加9.27 ml/s,IPSS平均降低15.86分,Qo L平均增加3.47分,PVR平均降低87.1 ml。患者术后效果满意率为72.0%。术后效果明显组术后IPSS、Qo L均显著低于效果不满意组[(4.47±3.92)分vs(8.93±7.13)分,(0.91±0.87)分vs(1.95±1.28)分,P均<0.01],Qmax显著增加[(20.52±8.54)ml/s vs(11.17±2.86)ml/s,P<0.01],而PVR无显著差异[(29.50±18.30)ml vs(39.10±48.20)ml,P=0.192]。术后效果明显组患者与效果不满意组患者相比,术中RPV变化无明显差异,RPV/TPV和RPV/TZV在术后效果明显组中显著高于效果不满意组(P=0.002和P=0.004)。RPV/TPV和RPV/TZV在预测术后疗效的ROC曲线下面积分别为0.793和0.687(P=0.001和P=0.009)。结论:TURP近期随访疗效与术中前列腺组织切除比例密切相关,RPV/TPV和RPV/TZV可能成为术后预测TURP疗效的新指标。
OBJECTIVE: To evaluate the effect of resected prostate volume (RPV) on postoperative IPSS, QoL scores and voiding function after transurethral resection of the prostate (TURP). Methods: From January 2012 to December 2014, 82 patients undergoing TURP and postoperative pathology were confirmed as BPH. IPSS, QoL, residual urine volume (PVR) and maximum urine Change in flow rate (Qmax). The total prostate volume (TPV) and the transition zone volume (TZV) were measured by ultrasound before operation, and the effects of RPV, RPV / TPV and RPV / TZV on TURP were analyzed. Results: At 3 months after TURP, Qmax increased by 9.27 ml / s, IPSS decreased by 15.86 points, Qo L increased by 3.47 points on average and PVR decreased by 87.1 ml on average. Patient satisfaction rate was 72.0%. After operation, the IPSS and QoL in the postoperative group were significantly lower than those in the unsatisfactory group [(4.47 ± 3.92) vs (8.93 ± 7.13) vs (0.91 ± 0.87) vs (1.95 ± 1.28) (P <0.01). There was no significant difference in PVR between the two groups [(29.50 ± 18.30) ml vs (39.10 ± 48.20) ml , P = 0.192]. There was no significant difference in RPV between the patients with obvious effect and the patients with unsatisfactory effect, and the RPV / TPV and RPV / TZV were significantly higher in the postoperative effect group than those in the unsatisfactory effect group (P = 0.002 and P = 0.004). The areas under the ROC curve of RPV / TPV and RPV / TZV in predicting the postoperative efficacy were 0.793 and 0.687 (P = 0.001 and P = 0.009), respectively. Conclusion: The effect of short-term follow-up of TURP is closely related to the proportion of resected prostate tissue. RPV / TPV and RPV / TZV may be the new indexes for predicting the effect of TURP after operation.