【摘要】 目的探讨经尿道前列腺等离子电切术（transurethral plasmakinetic prostatectomy,TUPKP）治疗前列腺增生（benign prostatic hyperplasia,BPH）伴逼尿肌收缩功能减退的疗效以及影响因素。方法回顾性分析48例BPH伴逼尿肌收缩功能减退患者行TUPKP治疗的临床资料。36例患者成功拔除导尿管视为有效组,12例患者无法拔管视为无效组。比较有效组患者术前与术后3个月的最大尿流率(Q_max)、残余尿量、国际前列腺症状评分（IPSS）、生活质量指数评分（QoL）,分析Q_max、残余尿量的改善与前列腺体积及逼尿肌收缩功能的相关性。收集两组患者的术前资料,对年龄、糖尿病史、IPSS、QoL、前列腺体积、残余尿量、逼尿肌收缩功能、膀胱出口梗阻程度行单因素分析,然后再行Logistic回归分析。结果有效组术后3个月Q_max、残余尿量、IPSS、QoL均较术前改善,差异有统计学意义（P<0.001）;Q_max、残余尿量的改善与前列腺体积及逼尿肌收缩功能正相关。单因素分析表明,前列腺体积、残余尿量、逼尿肌收缩功能、膀胱出口梗阻程度是影响患者术后疗效的重要因素;多因素分析表明,前列腺体积、残余尿量是其独立因素。结论前列腺增生伴逼尿肌收缩功能减退患者行TUPKP可取得较好效果,但需慎重选择病例,前列腺体积、残余尿量是影响疗效的独立因素。更多还原

【Abstract】 Objective To explore the efficacy of the transurethral plasmakinetic prostatectomy（TUPKP） in the treatment of benign prostatic hyperplasia（BPH） with detrusor underactivity. Methods Clinical data of 48 BPH patients with detrusor underactivity who underwent TUPKP were retrospectively analyzed, and 36 patients with successful removal of the catheter were taken as effective group, 12 patients with retention of the catheter as invalid group. Q_max, residual urine volume, IPSS, and QoL of the effective group were compared between preoperative and postoperative 3 months. The correlation between Q_max, residual urine volume and prostate volume and detrusor contractile function were analyzed. The age, history of diabetes, IPSS, QoL, prostate volume, residual urine volume, detrusor contractile function, bladder outlet obstruction were analyzed by univariate analysis. Factors found to be significant differences were further analyzed using logistic regression analysis. Results The Q_max, residual urine volume, IPSS, QoL of the effective group were significantly improved 3 months after operation. Q_max, residual urine volume improvement were positively correlated with prostate volume and detrusor contraction function. Univariate analysis showed that the prostate volume, residual urine volume, detrusor contraction function, bladder outlet obstruction were the effective factors. Multivariate analysis showed that the prostate volume or residual urine volume was an independent factor. Conclusion TUPKP was an effective treatment for BPH with detrusor underactivity, but it was necessary to select patients carefully. The prostate volume or residual urine volume was an independent factor.更多还原