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经尿道前列腺等离子切除术治疗良性前列腺增生伴高血压的效果研究

Effect of transurethral plasmakinetic resection of prostate in treating benign prostatic hyperplasia complicated with hypertension

    摘要
  • 摘要:
    目的 比较经尿道前列腺等离子切除术(TUPKRP)与药物治疗对伴高血压的良性前列腺增生人群血压及血压节律变化的影响。
    方法 回顾性纳入2021年6月—2023年6月本院103例良性前列腺增生患者为研究对象, 依据治疗方案的不同将其分为药物治疗组47例(采用替米沙坦联合非那雄胺治疗)和手术治疗组56例(采用替米沙坦联合TUPKRP治疗)。比较2组治疗前以及治疗3、6个月时血压水平(24 h平均舒张压、24 h平均收缩压、日间平均舒张压、日间平均收缩压、夜间平均舒张压和夜间平均收缩压)、血压节律变化(杓型血压)、前列腺症状、前列腺体积、残余尿量和性功能。
    结果 手术治疗组治疗3、6个月时不同时段平均血压低于药物治疗组，差异有统计学意义(P < 0.05); 手术治疗组治疗3、6个月时杓型血压转变率(67.86%、87.50%)高于药物治疗组(40.42%、68.09%)，差异有统计学意义(P < 0.05); 手术治疗组治疗3、6个月时国际前列腺症状评分(IPSS)、残余尿量、前列腺体积低于、小于药物治疗组，差异有统计学意义(P < 0.05); 2组治疗前以及治疗3、6个月时性功能比较，差异无统计学意义(P>0.05)。
    结论 替米沙坦联合TUPKRP可降低伴高血压的良性前列腺增生患者血压水平，调节血压节律变化，改善前列腺症状，缩小前列腺体积，减少残余尿量，且对患者性功能影响较小。

     

    Abstract:
    Objective To compare the effects of transurethral plasmakinetic resection of prostate (TUPKRP) and drug therapy on blood pressure and change of blood pressure rhythm in patients with benign prostatic hyperplasia complicated with hypertension.
    Methods A total of 103 patients with benign prostatic hyperplasia in the hospital from June 2021 to June 2023 were retrospectively enrolled as study objects. According to different treatment protocols, they were divided into drug therapy group with 47 cases (treated with telmisartan combined with finasteride) and surgical treatment group with 56 cases (treated with telmisartan combined with TUPKRP). Blood pressure levels (24-hour mean diastolic blood pressure, 24-hour mean systolic blood pressure, daytime mean diastolic blood pressure, daytime mean systolic blood pressure, nighttime mean diastolic blood pressure, nighttime mean systolic blood pressure), change of blood pressure rhythm (dipper blood pressure), prostate symptoms, prostate volume, residual urine volume, and sexual function were compared between the two groups before treatment and at 3 and 6 months after treatment.
    Results The mean blood pressure at different time points in the surgical treatment group was significantly lower than that in the drug therapy group at 3 and 6 months after treatment (P < 0.05). The conversion rates of dipper blood pressure in the surgical treatment group at 3 and 6 months after treatment were 67.86% and 87.50%, which were significantly higher than 40.42% and 68.09% in the drug therapy group (P < 0.05). International Prostate Symptom Score (IPSS), residual urine volume, and prostate volume in the surgical treatment group were significantly lower than those in the drug therapy group at 3 and 6 months after treatment (P < 0.05). There was no significant difference in sexual function between the two groups before treatment and at 3 and 6 months after treatment (P>0.05).
    Conclusion Telmisartan combined with TUPKRP can reduce blood pressure levels, regulate change of blood pressure rhythm, improve prostate symptoms, reduce prostate volume, and decrease residual urine volume in patients with benign prostatic hyperplasia complicated with hypertension, with minimal impact on sexual function.

     

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