超选择前列腺动脉栓塞联合经尿道前列腺切除术治疗体积>80 mL良性前列腺增生的临床疗效

目的比较超选择前列腺动脉栓塞(PAE)+经尿道前列腺切除术(TURP)与单纯TURP方案治疗前列腺体积>80 mL良性前列腺增生的疗效及安全性。方法回顾性分析我院2016年1月至2019年1月收治的84例体积>80 mL良性前列腺增生病人的临床资料,其中行单纯TURP治疗者44例为对照组,行超选择PAE+TURP治疗者40例为观察组。比较2组手术时间、切除病变组织重量和速率、膀胱持续冲洗时间、尿管留置时间、手术前后国际前列腺症状评分(IPSS)、生活质量(QOL)评分、最大尿流率(Qmax)、残余尿量(PVR)及术后并发症发生率。结果观察组手术时间、膀胱持续冲洗时间及尿管留置时间均显著少于对照组(P<0.05),切除病变组织重量和速率均显著高于对照组(P<0.05)。2组术后IPSS评分、QOL评分、Qmax及PVR水平差异均无统计学意义(P>0.05);观察组术后并发症发生率显著低于对照组(P<0.05)。结论对于体积>80 mL良性前列腺增生病人,超选择PAE+TURP方案较单纯TURP方案能够有效缩短手术时间,提高组织切除效率,加快术后康复进程,缓解临床症状,改善膀胱功能和生活质量,并有助于降低术后并发症发生风险。

Curative effect of super-selective prostatic artery embolization combined with transurethral prostatic resection for benign prostatic hyperplasia with volume>80 mL

Objective To investigate the clinical effects and safety of super-selective prostatic artery embolization(PAE)combined with transurethral resection of the prostate(TURP)in the treatment of benign prostatic hyperplasia with volume>80 mL in the elderly patients.Methods The clinical data of 84 elderly patients with benign prostatic hyperplasia with volume>80 mL treated in our hospital from January 2016 to January 2019 were retrospectively analyzed.The patients were divided into control group(44 patients,undergoing TURP)and observation group(40 patients,undergoing super-selective PAE and TURP).The operation time,weight and speed of excised lesion,continuous bladder flushing time,catheter retention time,International Prostate Symptom Score(IPSS),quality of life(QOL)score,maximum urinary flow rate(Qmax)and residual urine volume(PVR),and postoperative complications were compared between the two groups.Results Compared with the control group,the operation time,continuous bladder flushing time,catheter retention time in the observation group were significantly less(P<0.05),and the weight and speed of excised lesion were significantly more(P<0.05).After operation,there were no significant differences in IPSS score,QOL score,Qmax and PVR between the two groups(P>0.05),but the incidence rate of postoperative complication in observation group was significantly lower than that in control group(P<0.05).Conclusions Compared with TURP alone,super-selective PAE+TURP in the treatment of benign prostatic hyperplasia patients with volume>80 mL can efficiently shorten the operation time,increase the efficiency of tissue resection,speed up the rehabilitation process,relieve the clinical symptoms,improve the bladder function and quality of life,and reduce the postoperative complications risk.