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孟繁华 徐皖江 叶李银.腹腔镜下前列腺癌根治术的疗效及对患者尿流动力学、生活质量的影响[J].中国现代医生,2021,59(27):45-48
腹腔镜下前列腺癌根治术的疗效及对患者尿流动力学、生活质量的影响
Efficacy of laparoscopic radical prostatectomy and its influence on patients′ urodynamics and quality of life
  
DOI:
中文关键词:  腹腔镜  前列腺癌根治术  尿流动力学  并发症  生活质量
英文关键词:Laparoscopy  Radical prostatectomy  Urodynamics  Complications  Quality of life
基金项目:浙江省基础公益研究计划项目(LGF21H160018)
作者单位
孟繁华 徐皖江 叶李银 杭州市富阳区第一人民医院泌尿外科浙江杭州 311400 
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中文摘要:
      目的 探讨腹腔镜下前列腺癌根治术的疗效及对患者尿流动力学、生活质量的影响。方法 选择杭州市富阳区第一人民医院泌尿外科2017 年1 月至2019 年10 月期间收治的62例早期前列腺癌患者,随机分为两组,对照组(n=31)予开放性前列腺癌根治术治疗,观察组(n=31)则接受腹腔镜下前列腺癌根治术治疗,比较两组临床指标、术后并发症、尿流动力学指标及术前术后生活质量的变化,以及随访1 年的生化复发率。结果 观察组手术时间高于对照组,术中出血量少于对照组,术后导尿管留置、引流管拔除及肠道功能恢复、住院时间均短于对照组,术后并发症发生率明显低于对照组,差异有统计学意义(P<0.05);观察组充盈期膀胱顺应性值(Bladder compliance,BC)、残余尿量(Post-voiding residual,PVR)分别为(15.12±3.29)cm H2O、(88.12±20.42)mL,低于对照组的(17.47±3.67)cm H2O、(142.98±32.76)mL,最大尿流率(Qmax)、最大尿流率时逼尿肌压力(Pdet at Qmax)分别为(6.29±2.08)mL/s、(92.73±12.31)mL,高于对照组的(3.40±1.25)mL/s、(78.39±10.45)mL,差异有统计学意义(P<0.05);术后,两组QLQ-C30 量表各维度评分均有明显升高,且观察组高于对照组,差异均有统计学意义(P<0.05);观察组患者生化复发率为6.45%,与对照组的12.90%比较,差异无统计学意义(P>0.05)。结论 腹腔镜下前列腺癌根治术具有创伤小、术后并发症发生率低及术后恢复快的特点,且患者的尿流动力学恢复程度好、术后生活质量高。
英文摘要:
      Objective To investigate the efficacy of laparoscopic radical prostatectomy and its influence on patients′urodynamics and quality of life.Methods A total of 62 patients with early-stage prostate cancer admitted to the Department of Urology of Fuyang First People′s Hospital from January 2017 to October 2019 were randomly divided into two groups.The control group(n=31)were given open radical prostate cancer treatment and the observation group(n=31)were treated with laparoscopic radical resection of prostate cancer.The clinical indicators,postoperative complications,urodynamic indicators,and changes in quality of life before and after surgery,and biochemical recurrence rate at 1 year of follow-up were compared between the two groups.Results The operation time in the observation group was longer than that in the control group.The blood loss during operation in the observation group was less than that in the control group.The postoperative catheterization,drainage tube removal,intestinal function recovery,and hospital stay in the observation group were shorter than those in the control group.The incidence of postoperative complications in the observation group was significantly lower than that in the control group,with statistically significant difference(P<0.05).The levels of BC and PVR were(15.12±3.29)cmH2O and(88.12±20.42)mL,which were lower than those in the control group as(17.47±3.67)cmH2O and(142.98±32.76)mL.the levels of Qmax,and Pdet at Qmax were(6.29±2.08)mL/s and(92.73±12.31)mL,which were higher than those in the control group as(3.40±1.25)mL/s and(78.39±10.45)mL,with statistically significant differences(P<0.05).After operation,the scores of each dimension of the QLQ-C30 scale in both groups were significantly increased,and the scores in the observation group was higher than those in the control group,with statistically significant differences(P<0.05).The biochemical recurrence rate in the observation group was 6.45% and that in the control groups was 12.90%,without statistically significant difference (P>0.05).Conclusion Laparoscopic radical resection of prostate cancer has the characteristics of less trauma,low incidence of postoperative complications,fast postoperative recovery,good patient′s urodynamic recovery,and high postoperative quality of life.
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