经尿道前列腺等离子电切术后早期拔除导尿管初步探讨

目的:探讨经尿道前列腺等离子电切术(PKRP)后早期拔除导尿管的可行性及效果。方法:2012年3月至2013年2月采用PKRP术治疗良性前列腺增生(BPH)患者128例,随机分为两组,每组各64例,观察组术后1~2d拔除导尿管,对照组术后5~7d拔除导尿管,对比两组患者的术后指标,比较其临床效果。结果:两组患者术前情况无明显差异。观察组术后住院天数[(3.7±1.5)d]、泌尿系统感染发生率(10.9%)与对照组[(6.8±1.9)d、25.0%]比较有显著性差异(P均0.05)。两组患者术后随访3~6个月,3个月随访结果提示国际前列腺症状评分[(4.9±2.2)分vs(5.3±2.3)分]、最大尿流率[(21.5±5.6)ml/s vs(19.1±4.9)ml/s]、残余尿[(16.8±10.3)ml vs(18.9±12.3)ml]比较无显著差异(P均0.05)。两组间并发症比较无显著差异(P0.05)。结论:PKRP术后早期拔除导尿管住院时间更短、感染发生率更低,且不影响远期效果,值得提倡推广,使之逐渐成为PKRP术后处理常规。

Early removal of the urethral catheter after transurethral plasma kinetic resection of the prostate in the treatment of BPH

Objective ： To investigate the feasibility and effect of early removal of the urethral catheter after transurethral plasma kinetic resection of the prostate （PKRP） in the treatment of benign prostatic hyperplasia （BPH）. Methods： We equally randomized 128 BPH patients treated by PKRP to an experimental group and a control group, urethral catheters removed at 1 -2 days for the former and at 5 - 7 days for the latter. We compared the relevant indexes and clinical effects between the two groups. Results ： The baseline data were not significantly different between the two groups. Compared with the controls, the experimental group showed a significantly shorter postoperative hospital stay （ [ 6.8 _＋ 1.9 ~ d vs [ 3.7 ＋ 1.5 ] d, P 〈 0.05 ） and lower infection rate （25.0% vs 10.9%, P 〈 0.05）. All the patients were followed up for 3 - 6 months postoperatively. At 3 months after surgery, both the experimental and the control groups showed remarkable improvement in the International Prostatic Symptoms Scores （4.9 ± 2.2 vs 5.3 ± 2.3 ） , maximum urine flow rate （[21.5 ± 5.63 ml/svs [19.1 ± 4.9] ml/s）, and residual urine （[16.8 ± 10.3] mlvs [18.9 ± 12.3] ml）, but with no significant differences between the two （P 〉 0.05）, and no significant differences were observed in postoperative complications （ P 〉 O. 05）. Conclusion ： Early removal of the urethral catheter after PKRP, with its advantages of shorter postoperative hospital stay,lower infection rate, and no influence on the long-term effect, deserves to be recommended as a routine method in the treatment of BPH. Natl J Androl, 2014, 20 （3） ： 249-252