郑汉雄 郑少波 夏昕晖 徐啊白 吴炜嘉

【摘要】目的：探讨改良Nesbit方式经尿道前列腺电切术对前列腺增生合并糖尿病患者生活质量的影响。方法：2012年8月至2015年2月选择在我院诊治的前列腺增生合并糖尿病患者90例，根据随机双盲法分为治疗组与对照组各45例，血糖控制在正常范围后对照组采用Nesbit法经尿道前列腺电切术，治疗组采用改良Nesbit法经尿道前列腺电切术。结果：在手术时长、出血程度、手术之后膀胱冲洗和住院时长等方面治疗组均比对照组少很多（P<0.05），治疗组术后经尿道电切综合征、切口出血、尿路感染等并发症发生情况明显少于对照组（P<0.05）。治疗组与对照组治疗后的尿流率为（10.35±2.49）mL/s和（8.13±2.11）mL/s，都明显高于治疗前的（3.45±1.89）mL/s和（3.41±2.00）mL/s（P<0.05），同时组间对比差异也有统计学意义（P<0.05）。术后1个月经过调查，治疗组的躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖评分都明显低于对照组（P<0.05）。结论：对于前列腺增生合并糖尿病病人，采取改良Nesbit方式经尿道前列腺电切术医治的效果较好，微创伤更小，能减少术后并发症的发生，改善尿动力学，从而有利于生活质量的提高。

【关键词】改良Nesbit法；经尿道前列腺电切术；前列腺增生；糖尿病；生活质量

【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

【中图分类号】R697+.3【文献标志码】A

前列腺增生症是老龄化社会中老年男性最常见的疾病之一，也是最容易导致男性排尿障碍的疾病。随着诊断技术的提高与老年人口的增加，我国前列腺增生症患者越来越多[1]。国内现阶段糖尿病病人数量大于4千万，人类健康已经受到了该疾病的严重威胁，同时糖尿病病人合并前列腺增生的数目也不断增加[2]。尽管目前正逐渐改善治疗糖尿病的技术，医治前列腺增生的效果也越来越好，然而手术技术还要更深入地改善[3，4]。目前医治前列腺增生的行业最高标准就是经尿道前列腺电切术[5]，然而因为糖尿病病人的内分泌系统紊乱，无法正常代谢，所以应激反应会因为手术造成的创伤引起，这样的后果是体内血糖含量提升，各种并发症出现的几率增大，手术风险也随之增加，降低了患者的术后生活质量[6-8]。……