Feasibility Analysis of Short-term Indwelling Urete after PKEP
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摘要:
目的 探讨经尿道双极等离子前列腺剜除术（transurethral plasmamakinetic enucleation surgery，PKEP）术后患者短期留置尿管的可行性。 方法 回顾性分析2019年2月至2019年12月昆明医科大学附属延安医院收治且采用PKEP治疗良性前列腺增生（benign prostatic hyperplasia，BPH）的89例患者的临床资料，将其分为对照组和观察组，其中对照组PKEP术后留置尿管，观察组行PKEP术后短期留置尿管，对比2组的手术时间、术中出血量、切除腺体重量等相关指标。 结果 对照组与观察组的手术时间[（58.40±23.10 ） min vs （67.40±29.80） min]、切除腺体重量[（54.90±16.60 ） g vs （ 61.20±21.50 ） g]、术中出血量[（31.70±13.60 ） mL vs （35.50±19.20） mL]相比较，差异无统计学意义（P > 0.05）。但观察组住院时间[（10.80±3.90 ） d vs （13.70±4.60 ） d]、住院费用[（1.06±0.49） d vs （1.38±0.53） d]显著低于对照组（P < 0.05）。在术后1周尿潴留、尿路感染、尿失禁等并发症的发生率上，2组之间的差异无统计学意义（P > 0.05）。 结论 术者严格遵守PKEP操作规范后，术后短期留置尿管在不增加术后并发症发生率的前提下，还能缩短患者住院时间、降低住院费用。既达到了良好的治疗效果，且减轻了患者的经济负担，具有一定的可行性。 Abstract:Objective To explore the feasibility of short-term indwelling urete in patients aftert PKEP （transurethral plasmamakinetic enucleation surgery）. Methods We performed a retrospective analysis of the clinical data of 89 patients with benign prostatic hyperplasia （BPH） and treated with PKEP in Yan'an Hospital Affiliated to Kunming Medical University from February 2019 to December 2019. These patients was divided into control group and observation group. The control group was given indwelling with the urine after PKEP, and the observation group left the urete after PKEP short-termly. Compared to the operation time, intraoperative blood volume, resection of gland weight, and other related indicators. Results The surgical time of the control group and the observation group was [（58.40 ± 29.80） min vs （67.40 ± 29.80） min], the weight of the gland was [（54.90 ± 16.60） g vs （61.20 ± 21.50） g], the volume of intraoperative bleeding was [（35.50 ± 13.20） mL vs （35.50 ± 19.20） mL], the difference was not statistically significant （P > 0.05）. However, the observation group was hospitalized [（10.80 ± 3.90） D], hospitalization cost [（1.06 ± 0.49） D VS. （1.38 ± 0.53） d] was significantly lower than that in the control group （P < 0.05） . There was no significant difference between the two groups （P > 0.05） in the incidence of urinary retention, urinary tract infection, urinary incontinence complications. Conclusions After the operator strictly abides by the PKEP operating standard, postoperative short-term indwelling urete can shorten the hospitalization time and reduce the hospitalization cost without increasing the incidence of postoperative complications. It not only achieves a good therapeutic effect, but also reduces the economic burden of patients. These findings verifies the feasibility of this method. -
表 1 患者术前的的一般资料（
$\bar x \pm s $ ）Table 1. General clinical data of patients before operation （
$\bar x \pm s $ ）组别 n 年龄
（岁）术前前列腺
重量（g）Qmax
（mL/s）PVR
（mL/s）PSA
（ng/mL）IPSS
（分）QOL
（分）并发症（n） 心血管
疾病呼吸系统
疾病观察组 38 72.260 ± 5.780 63.400 ± 23.100 7.400 ± 2.500 173.800 ± 36.200 3.400 ± 1.200 26.300 ± 5.900 3.800 ± 0.900 18 21 对照组 51 72.550 ± 6.130 70.300 ± 20.800 8.300 ± 3.900 181.900 ± 43.600 3.800 ± 1.500 24.800 ± 6.100 4.200 ± 1.500 28 36 t/ x² 1.349 1.476 1.244 0.931 1.352 1.164 1.459 0.495 2.221 P 0.090 0.072 0.108 0.177 0.090 0.124 0.074 0.182 0.136 PSA = 前列腺特异性抗原； Qmax = 最大尿流率；PVR = 残余尿量； IPSS = 国际前列腺症状评分；QOL = 生活质量评分。 
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表 2 2组手术情况对比（
$\bar x \pm s $ ）Table 2. Comparison of the operation information of the 2 groups （
$\bar x \pm s $ ）组别 n 术中出血量（mL） 手术时间（min） 前列腺切除重量（g） 住院时间（d） 住院费用/（万元） 观察组 38 31.700 ± 13.600 58.400 ± 23.100 54.900 ± 16.600 10.800 ± 3.900 1.060 ± 0.490 对照组 51 35.500 ± 19.200 67.400 ± 29.800 61.200 ± 21.500 13.700 ± 4.600 1.380 ± 0.530 t 1.040 1.083 1.503 3.135 2.909 P 0.151 0.141 0.068 0.001* 0.002* *P < 0.05。
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表 3 术后2组尿潴留的情况[n（%）]
Table 3. Comparison of the postoperative urinary retention of the 2 groups [n（%）]
组别 n 3 d 观察组 38 2（5） 对照组 51 0 χ2 - 0.873 P - 0.350
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表 4 术后2组尿失禁的情况[n（%）]
Table 4. Comparison of the postoperative urinary incontinence of the 2 groups [n（%）]
组别 n 1周 2周 3周 观察组 38 3（7） 1（2.6）） 0 对照组 51 6（11.8） 4（7.8） 1（1.9） χ2 - 0.059 0.349 0.022 P - 0.081 0.554 0.882
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表 5 术后2组泌尿系统感染的情况[n（%）]
Table 5. Comparison of the postoperative urinary system infection of the 2 groups [n（%）]
组别 n 3 d 1周 观察组 38 1（2.6） 0 对照组 51 11（21.5） 2（3.9） χ2 - 5.169 0.262 P - 0.003* 0.609 *P < 0.05。
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