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目的研究良性前列腺增生患者经尿道前列腺切除术后排尿症状的变化及其与术前临床参数的关系。方法对281例良性前列腺增生手术患者进行随访,对其手术前、后排尿症状评分-和术前临床资料进行分析。患者年龄(70±6)岁。术前前列腺体积(75±39)ml,血清总前列腺特异性抗原(T-PSA)(5±5)ng/ml,最大尿流率(8±3)ml/s,切除前列腺重量(32±19)g。术前国际前列腺症状评分(IPSS)(24±7)分,生活质量评分(QOL)(4.6±1_0)分,平均梗阻症状(3.6±1.2)分,平均刺激症状(3.5±1.0)分。结果术后 IPSS(7±7)分,生活质量评分(1.2±1.1)分,与术前相比,均明显改善。不同排尿症状改善的幅度不同,平均梗阻症状的改善幅度大于平均刺激症状的改善。术后夜尿和尿频分别为(2.2±1.1)分和(1.2±1.4)分。结论经尿道前列腺切除患者术后排尿症状明显改善,症状的改善程度与术前 IPSS 和 QOL 相关,而与患者年龄、术前前列腺体积、T-PSA、最大尿流率、切除前列腺重量无相关性。梗阻症状的改善优于刺激症状的改善,而夜尿是改善幅度最小的症状。
Objective To study the changes of urinary symptoms after transurethral resection of prostate in patients with benign prostatic hyperplasia and its relationship with preoperative clinical parameters. Methods A total of 281 patients with benign prostatic hyperplasia (BPH) surgery were followed up and their urinary symptoms before and after surgery were analyzed. The clinical data were analyzed before operation. The patient’s age (70 ± 6) years old. Preoperative prostate volume (75 ± 39) ml, total T-PSA (5 ± 5) ng / ml, maximum uroflow rate (8 ± 3) ml / 19) g. Preoperative International Prostate Symptom Score (IPSS) (24 ± 7), quality of life score (QOL) (4.6 ± 1_0), mean symptom of obstruction (3.6 ± 1.2) and average irritation symptom (3.5 ± 1.0). Results Postoperative IPSS (7 ± 7) points, quality of life score (1.2 ± 1.1) points, compared with preoperative, were significantly improved. The rate of improvement of different urination symptoms was different, and the improvement of average obstruction symptom was greater than the improvement of average irritation symptom. Postoperative nocturia and urinary frequency were (2.2 ± 1.1) points and (1.2 ± 1.4) points. Conclusions The postoperative urinary symptoms in patients undergoing transurethral resection of the prostate are significantly improved. The improvement of symptoms is related to the preoperative IPSS and QOL, but not to the patient’s age, preoperative prostate volume, T-PSA, maximal uroflow rate, and the removal of prostate weight . Improvements in obstructive symptoms were superior to those in stimulating symptoms, whereas nocturia was the symptom of the least improvement.