经会阴模板引导前列腺穿刺对短期内经尿道前列腺等离子剜除术的影响

李凯; 李菘; 唐帅; 于大海; 张晓光; 张名浩; 马振; 陈方敏

doi:10.13201/j.issn.1001-1420.2021.08.006

经会阴模板引导前列腺穿刺对短期内经尿道前列腺等离子剜除术的影响

- 南开大学附属天津市第三中心医院泌尿外科(天津, 300170)
基金项目:
天津市津门医学英才培养计划资助(No:津人才2018-19)

详细信息

通讯作者: 陈方敏,E-mail:cfm_cn@aliyun.com

中图分类号: R697

收稿日期: 2020-12-07

Effect of transperineal template-guided prostate biopsy on closely followed transurethral plasmakinetic enucleation of prostate

- Department of Urology, Tianjin Third Central Hospital Affiliated to Nankai University, Tianjin, 300170, China

More Information

Corresponding author: CHEN Fangmin, E-mail: cfm_cn@aliyun.com

Received Date: 07 December 2020

摘要

摘要: 目的:探讨经会阴模板引导前列腺投影穿刺活检术(TTPMB)对短期内行经尿道前列腺等离子剜除术(PKEP)的影响。方法:收集2017年5月—2019年11月期间我院连续71例行PKEP的患者临床资料。28例术前7~10 d有TTPMB史的患者列入TTPMB组;43例术前无前列腺活检术(NPB)史的患者列入NPB组。围手术期资料包括:年龄、前列腺特异抗原(PSA)、前列腺体积、最大尿流率(Q_max)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)、膀胱出口梗阻指数(BOOI)、手术时间、血红蛋白下降程度、术后冲洗时间、术后冲洗液用量、尿管留置时间、输血量、术后排尿和尿失禁情况。随访1年收集资料包括Q_max、IPSS、QOL。结果:两组均顺利完成手术,无ClavienⅡ级以上并发症。NPB组对比TTPMB组的手术时间、血红蛋白下降程度、术后冲洗时间、术后冲洗液用量、尿管留置时间结果为:(85.6±15.09) min vs.(89.32±11.86) min、(4.14±1.04) g/L vs.(3.72±1.03) g/L、(15.81±4.04) h vs.(15.39±3.75) h、(16.53±5.24) L vs.(15.29±4.09) L、(59.49±11.46) h vs.(60.75±11.33) h,以上比较均差异无统计学意义(P＞0.05)。前列腺体积＜80 mL分层分析:NPB组vs.TTPMB组手术时间为(81.32±12.35) min vs.(88.47±11.91) min(P＜0.05)。术后无真性尿失禁,6例因不同原因失访,共有65例完成1年的随访,术后3、6、12个月均未观察到两组间Q_max、IPSS、QOL的差异有统计学意义。结论:TTPMB后短期内可以行PKEP,由此减少住院次数符合新型冠状病毒肺炎防疫要求,当前列腺体积＜80 mL时手术时间略有延长。
- 良性前列腺增生 /
- 经尿道前列腺等离子剜除术 /
- 经会阴模板引导前列腺投影穿刺活检术
Abstract: Objective: To investigate the effect of transperineal template-guided prostate mapping biopsy(TTPMB) on transurethral plasmakinetic enucleation of the prostate(PKEP).Methods: Clinical data of 71 consecutive patients with PKEP from May 2017 to November 2019 were collected. Twenty-eight patients with a history of TTPMB from 7 days to 10 days before operation were included in the TTPMB group, while 43 patients without a history of prostate biopsy(Non-prostate biopsy, NPB) were included in the NPB group. Perioperative data included age, prostate specific antigen(PSA), prostate volume, maximum urinary flow rate(Q_max), International Prostate Symptom Score(IPSS), quality of life score(QOL), postvoid residual(PVR), bladder outlet obstruction index(BOOI), operation time, hemoglobin decline degree, postoperative irrigation time, postoperative irrigation fluid consumption, catheter indwelling time, blood transfusion, urination and incontinence. One-year follow-up data were collected including Q_max, IPSS and QOL.Results: The operations were successfully completed in both groups without Clavien grade II or above complications. The operation time, hemoglobin decrease degree, postoperative flushing time, amount of flushing fluid and indwelling time of catheter were(85.6±15.09) min vs.(89.32±11.86) min,(4.14±1.04) g/L vs.(3.72±1.03) g/L,(15.81±4.04) h vs.(15.39±3.75) h,(16.53±5.24) L vs.(15.29±4.09) L,(59.49±11.46) h vs.(60.75±11.33) h in NPB and TTPMB groups respectively(all P＞0.05). Operation time of NPB group and TTPMB group were(81.32±12.35) min vs.(88.47±11.91) min(P＜0.05) in the patients with prostate volume less than 80 mL. There was no real urinary incontinence after operation. There was no statistic significance between the NPB group and TTPMB group in Q_max, IPSS or QOL during the follow-up period of 3 months, 6 months or 12 months in 65 patients.Conclusion: PKEP can be performed after TTPMB in the short term, so that COVID-19 prevention requirement can be met. When the volume of the gland was less than 80 mL, the operation time was slightly prolonged.

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