| Benign prostatic hyperplasia (BPH) is characterised clinically by lowerurinary tract symptoms (urinary frequency, urgency, a weak and intermittentstream, needing to strain, asenseof incomplete emptying, and nocturia),andcan lead to complications, including acute urinary retention, bladder functiondisorder, calculus, urinary tract infection, hematuria and renal functionlesion.Epidemiologic studys indicate the incidence of histological BPH increaseswith age augmentation. The histological BPH proceeds in 40s first and morethan 50% in 60s, 83% in 80s. Same as histological representation, clinicalsymptoms increase with age augmentation too. Along with our country populationsenescence, BPH will influence more and more old men's health.Evidence based medicine requests the individualization diagnoses andtreatment project of BPH should depend on digitization guide, doctor'sexperience and patient's wish. But we haven't the unified BPH diagnoses andtreatment guide for Chinese. So urologists formulate the diagnoses andtreatment project of BPH without guide. Their project wash't accurate, thissituation is disadvantage for patients and may cause medical treatmentresources waste.Benign prostatic hyperplasia is a kind of chronic progressing disease.One reasonable and scientific therapeutic regimen should synthetize variousfactors such as age, physiclal status, self symptom and objective examination of BPH and based on the turnover regulation of different BPH patients withdifferent feature and consider the cost and wish of patients. Only in thissituation, the object of individualization and precise treatment can come true.The treatment will cost less medical treatment resources and get bettertherapeutic effect.For this reason, to research BPH patient's correlated indexsystematically and prospectively, to summary the turnover regulation ofdifferent BPH patients under different therapeutic regimen and to analysisthe ratio between cost and effect have favourable clinical reference value.Our study researched a series of BPH patient's correlated indexsystematically and prospectively.Objective:TO follow-up visit the baseline data, therapeutic effect, turnover regulation,cost and side effect of benign prostatic hyperplasia patients interfered inthree treatment projects: watchful waiting, drug treatment and operationtreatment;to provide analytic result for reasonable and scientifictherapeutic regimen of BPH.Method:With the precondition of the unified reception standard and unifiedmeasurements, according to the present diagnoses and treatment practically,combining the judzement of doctors, the condition and wish of patients,doctors and patients selected the therapeutic regimen together(includingwatchful waiting, drug treatment and operation treatment). The follow-up ofthe age, BPH self symptom (IPSS score and QOL score),objective examinationindex(including prostatic volume, serum PSA, max urine flow rate, average urineflow rate, urinary output, residual urine) were recorded. SAS statisticssoftware was applied to manipulate the follow up data. The patients indifferent therapeutic regimen were stratified and analyzed with statisticalmethod. The patient's condition progression, therapeutic effect, quality of life and cost, side effect were studied and researched.Result:1. Baseline observation discovered that the mean of age were 63.08 in thewatchful waiting group, 67.50 in drug treatment group and 70.56 in operationtreatment group (F=22.45, P＜0.0001). While the mean of QOL scores were2.54,3.68,5.69 (F=228.08, P＜0.0001); the mean of IPSS scores were7.13,14.57,22.97(F=131. 72,P＜0.0001);the mean of PSAwere 1.53,1.99, 5.44ng/ml(F=50.72, P＜0.0001); the mean of max urine flow rate were 17.11, 12.36,9.09ml/s (F=42.04, P＜0.0001); the mean of prostatic volume were32.98,40.07,65.51mi (F=42.04, P＜0.0001), in the three group. Group comparisonhad statistics difference.2. Our follow-up discovered there was difference therapeutic effect betweentoperation treatment and drug treatment. Compared with basal line, drugtreatmen and operation treatment had improved QOL score 1,4; IPSS score 6,16;max urine flow rate 2.66,14.18ml/s; diminished prostatic volume 4.48, 30.06ml respectively at the 19th-24th momth.3. We have studyied the economy therapeutic effect ratio. At the 24th momtheach IPSS score was improved by drug treatment, the average cost was 641. 44yuan RMB. While operation treatment, 665.05 yuan RMB.Conclusion:1. The baseline of the self symptom (IPSS and QOL score) and the objectiveexamination index (prostatic volume, serum PSA, max urine flow rate, averageurine flow rate, urinary output, residual urine) in different groups patientsexisted statistics difference2. Operation treatment can improve the self symptom and the objectiveexamination index more effectively than drug treatment.3. At the 24th momth the economy therapeutic effect ratio betweent operationtreatment and drug treatment was similar.4. To identify the indication of different treatment, the factors such as the baseline and follow up date, economy therapeutic effect ratio, side effectshould be considered synthetically. |
