经尿道前列腺等离子剜除术合并无张力疝修补术对前列腺增生症并发腹股沟疝的应用效果研究

目的分析经尿道前列腺双极等离子剜除术（TBPKEP）合并无张力疝修补术对前列腺增生（BPH）并发腹股沟疝的应用效果。 方法收集2017年7月至2019年5月庐江县人民医院泌尿外科就诊的BPH并发腹股沟疝患者40例。根据手术方法分为对照组和观察组，每组20例。对照组患者采用经尿道前列腺双极等离子电切术（TUPKVP）合并无张力疝修补术进行治疗；观察组患者采用TBPKEP合并无张力疝修补术进行治疗。记录2组患者手术时间、术中出血量、切除组织量、术后国际前列腺症状评分（IPSS）和生活质量指数评分（QOL）、最大尿流量（Qmax）、残余尿量（RUV）。并发症发生率以百分率（%）标示，采用χ²检验进行比较；计量单位均采用均数±标准差（ ±s）表示，组间比较和组内比较分别采用t检验和配对t检验。 结果观察组手术时间（59.35±12.19）min短于对照组（72.24±15.34）min，差异有统计学意义（t=2.942，P<0.05）；观察组术中出血量（174.22±56.14）ml均显著低于对照组（296.08±67.33）ml，切除组织量（48.25± 13.42）g显著高于对照组（29.28±10.61）g，差异有统计学意义（t=6.217、4.959，P<0.05）。术后2组IPSS和QOL评分均显著低于术前，差异有统计学意义（P<0.05）；对照组显著高于观察组，差异有统计学意义（P<0.05）。术后，2组Qmax显著升高，RUV显著降低，差异有统计学意义（P<0.05）。其中，术后观察组Qmax显著高于对照组，RUV显著低于对照组，差异有统计学意义（P<0.05）。 结论与TUPKVP合并无张力疝修补术相比，TBPKEP合并无张力疝修补术治疗BPH合并腹股沟疝能显著增大患者尿流量，降低患者残余尿量，改善患者前列腺症状及患者生活质量。

Study on effect of transurethral prostatic plasma enucleation combined with tension-free herniorrhaphy on the treatment of prostatic hyperplasia complicated with inguinal hernia

ObjectiveTo analyze the effect of transurethral prostate bipolar plasma enucleation (TBPKEP) combined with tension-free herniorrhaphy in the treatment of benign prostatic hyperplasia (BPH) complicated with inguinal hernia. MethodsBetween July 2017 and May 2019, 40 patients with BPH complicated with inguinal hernia in Lujiang county people's hospital were divided into control group and observation group according to the surgical method, with 20 cases in each group. Patients in the control group were treated with TUPKVP combined with tension-free herniorrhaphy, while patients in the observation group were treated with TBPKEP combined with tension-free hernia repair. Operative time, intraoperative blood loss, tissue removal, and postoperative the score of international prostate symptom (IPSS), the score of quality of life (QOL), residual urine volume (RUV) and maximum urine flow rate (Qmax), were compared between the two groups. ResultsThe operative time of the observation group was shorter than that of the control group (P<0.05). The amount of tissue excised was significantly higher than the control group (P<0.05), and the intraoperative blood loss in the control group was significantly higher than the observation group (P<0.05). After surgery, the scores of IPSS and QOL in the two groups were significantly lower than before surgery (P<0.05), and after surgery the scores of IPSS and QOL in the observation group were significantly lower than the control group (P<0.05). After surgery, RUV was significantly decreased and Qmax was significantly increased in both groups (P<0.05), and Qmax in the observation group was significantly higher than the control group (P<0.05), and RUV was significantly lower than the control group (P<0.05). ConclusionCompared with TUPKVP combined with tension-free herniorrhaphy, TBPKEP combined with tension-free herniorrhaphy for prostate hyperplasia combined with inguinal hernia can significantly increase urine flow, reduce residual urine volume, improve prostate symptoms and quality of life of patients.