改良Nesbit方式經(jīng)尿道前列腺電切術(shù)對前列腺增生合并糖尿病患者生活質(zhì)量的影響

鄭漢雄 鄭少波 夏昕暉 徐啊白 吳煒嘉

【摘要】目的：探討改良Nesbit方式經(jīng)尿道前列腺電切術(shù)對前列腺增生合并糖尿病患者生活質(zhì)量的影響。方法：2012年8月至2015年2月選擇在我院診治的前列腺增生合并糖尿病患者90例，根據(jù)隨機雙盲法分為治療組與對照組各45例，血糖控制在正常范圍后對照組采用Nesbit法經(jīng)尿道前列腺電切術(shù)，治療組采用改良Nesbit法經(jīng)尿道前列腺電切術(shù)。結(jié)果：在手術(shù)時長、出血程度、手術(shù)之后膀胱沖洗和住院時長等方面治療組均比對照組少很多（P<0.05），治療組術(shù)后經(jīng)尿道電切綜合征、切口出血、尿路感染等并發(fā)癥發(fā)生情況明顯少于對照組（P<0.05）。治療組與對照組治療后的尿流率為（10.35±2.49）mL/s和（8.13±2.11）mL/s，都明顯高于治療前的（3.45±1.89）mL/s和（3.41±2.00）mL/s（P<0.05），同時組間對比差異也有統(tǒng)計學意義（P<0.05）。術(shù)后1個月經(jīng)過調(diào)查，治療組的軀體化、強迫、人際關(guān)系、抑郁、焦慮、敵對、恐怖評分都明顯低于對照組（P<0.05）。結(jié)論：對于前列腺增生合并糖尿病病人，采取改良Nesbit方式經(jīng)尿道前列腺電切術(shù)醫(yī)治的效果較好，微創(chuàng)傷更小，能減少術(shù)后并發(fā)癥的發(fā)生，改善尿動力學，從而有利于生活質(zhì)量的提高。

【關(guān)鍵詞】改良Nesbit法；經(jīng)尿道前列腺電切術(shù)；前列腺增生；糖尿病；生活質(zhì)量

【Abstract】Objectives： To investigate the effects of modified Nesbit transurethral resection on quality of life of diabetic patients with benign prostatic hyperplasia. Methods： 90 diabetic patients with benign prostatic hyperplasia from August 2012 to February 2015 in our hospital were selected and randomly divided into treatment group and control group. The blood glucose levels of them were controlled in the normal range. The control group was given the Nesbit TURP， and the treatment group was given the modified Nesbit TURP. Results： The operative time， blood loss， postoperative bladder irrigation time and postoperative hospital stay in treatment group were significantly less than these in control group （P<0.05）. The1-month postoperative transurethral resection syndrome， wound bleeding， urinary tract infections and other complications in treatment group were significantly less than these in control group （P<0.05）. The postoperative urinary flow rates of the two groups were 0.35±2.49ml / s and 8.13±2.11ml / s， which were all significantly higher than the preoperative values of 3.45±1.89ml / s and 3.41±2.00ml / s （P<0.05）， with statistically significant difference （P<0.05）. By investigation 1 month after the operation， the somatization， compulsion， interpersonal sensitivity， depression， anxiety， hostility， phobic scores in treatment group were significantly lower than these in control group （P<0.05）. Conclusion： The modified Nesbit TURP for diabetic patients with benign prostatic hyperplasia has better effect， which can reduce the incidence of postoperative complications and improve urodynamics， thusly contributing to improve quality of life.

【Key words】Modified Nesbit method； Transurethral resection； Prostatic hyperplasia； Diabetes； Quality of life

【中圖分類號】R697+.3【文獻標志碼】A

前列腺增生癥是老齡化社會中老年男性最常見的疾病之一，也是最容易導致男性排尿障礙的疾病。隨著診斷技術(shù)的提高與老年人口的增加，我國前列腺增生癥患者越來越多[1]。國內(nèi)現(xiàn)階段糖尿病病人數(shù)量大于4千萬，人類健康已經(jīng)受到了該疾病的嚴重威脅，同時糖尿病病人合并前列腺增生的數(shù)目也不斷增加[2]。盡管目前正逐漸改善治療糖尿病的技術(shù)，醫(yī)治前列腺增生的效果也越來越好，然而手術(shù)技術(shù)還要更深入地改善[3，4]。目前醫(yī)治前列腺增生的行業(yè)最高標準就是經(jīng)尿道前列腺電切術(shù)[5]，然而因為糖尿病病人的內(nèi)分泌系統(tǒng)紊亂，無法正常代謝，所以應(yīng)激反應(yīng)會因為手術(shù)造成的創(chuàng)傷引起，這樣的后果是體內(nèi)血糖含量提升，各種并發(fā)癥出現(xiàn)的幾率增大，手術(shù)風險也隨之增加，降低了患者的術(shù)后生活質(zhì)量[6-8]。……