经尿道前列腺电汽化术及等离子电切术后5年疗效随访  

Five-years follow-up after transurethal electrovaporization of the prostate and transurethal plasmakinetic resection of the prostate

作　　者：龚旻[1] 伊庆同[1] 胡巍[1] 祝凤明[1] 顾建军[1] 陈楚红[1] 郭建华[1] 田斌强[1] 陈长青[1] 

机构地区：[1]上海市浦东新区南汇中心医院泌尿外科,201300

出　　处：《中华泌尿外科杂志》2012年第5期364-368,共5页Chinese Journal of Urology

摘　　要：目的观察经尿道前列腺电汽化（transurethal electrovaporization of the prostate，TUVP）、经尿道前列腺等离子电切（transurethal plasmakinetic resection of the prostate，PKRP）术后患者的远期主要并发症，探讨常见并发症的原因及防治措施。方法回顾性分析92例TUVP、226例PKRP患者的临床资料，随访患者术后1、3、5年的相关情况，包括患者主观症状（如IPSS、QOL）、客观指标（如血清PSA、Qmax、残余尿量）、远期主要并发症等。对术后出现的并发症或其他疾病采取相应的治疗方法。结果TUVP、PKRP术后1年患者IPSS[（7．3±2．8），（7．2±2．5）分]、QOL[（2．6±0．7），（2．7±0．5）分]、Qmax[（25．2±3．5），（25．5±3．8）ml／s]、残余尿量[（18．7±5．4），（17．8±6．3）m1]，组间比较差异无统计学意义（P〉0．05）；术后3年患者IPSS[（7．4±2．6），（7．5±2．9）分]、QOL[（2．7±0．4），（2．7±0．9）分]、Qmax[（24．8±3．3），（25．0±4．2）ml／s]、残余尿量[（19．4±6．0），（18．3±6．7）ml]，组间比较差异无统计学意义（P〉0．05）；术后5年患者IPSS[（7．5±3．1），（7．6±2．7）分]、QOL[（2．7±0．8），（2．8±0．6）分]、Qmax[（24．1±4．4），（24．8±4．5）ml／s]、残余尿量[（20．1±5．8），（19．0±7．1）ml]，组间比较差异无统计学意义（P〉0．05）。TUVP组术后1、3、5年膀胱颈挛缩发生率为1．1％、3．3％和2．3％，尿道狭窄为3．3％、2．2％和1．1％，前列腺残留腺体增生为1．1％、2．2％和4．5％；PKRP组膀胱颈挛缩发生率为0．9％、2．7％和1．8％，尿道狭窄发生率为3．1％、2．2％和0．9％，前列腺残留腺体增生为1．3％、2．7％和3．7％。结论TUVP、PKRP治疗BPH具有良好的安全性和临床疗效。膀胱颈挛缩、尿道狭窄、前列腺残留腺体增生仍是TUVP、PKRP术后患者的远期主要并发症Objective To review the major complications in patients after transurethal electrovaporization of the prostate （TUVP） and transurethal plasmakinetic resection of the prostate （PKRP） retrospectively and to analyze the causes and management. Methods Clinical data of 92 cases of patients after TUVP and 226 cases after PKRP were reviewed retrospectively. The patients＇ relevant circumstances including subjective symptoms, objective indexes and the major long-term complications were followed up about 1-, 3-, and 5-year after operation. Different therapeutic methods were chosen according to different causes of the complications. Results There were no significant differences （ P 〉 0.05 ） between TUVP group and PKRP group in IPSS （7.3±2.8, 7.2 ±2.5）, QOL （2.6 ±0.7, 2.7±0.5）, Qm,x[ （25.2 ±3.5）, （25.5 ±3.8） ml/s] and PVR [（18.7±5.4）, （17.8 ±6.3）ml]. The incidences of bladder neck restriction was about 1. 1%, 3.3% , and 2.3% after 1, 3, and 5 years in patients after TUVP, and 0.9%,2.7% , and 1.8% after PKRP accordingly. For urethral stricture, it was about 3.3% , 2.2% , and 1.1% after TUVP, and 3.1% , 2.2% , and 0.9% after PKRP. For residual prostatic hyperplasia, it was about 1.1% , 2.2% , and 4. 5% after TUVP, and 1. 3%, 2. 7%, and 3. 7% after PKRP accordingly. Conclusions TUVP and PKRP are effective and safe treatment options for BPH. The major long-term complications after TUVP and PKRP are bladder neck restriction, urethral stricture and residual prostatic hyperplasia. Regular and long-term follow-up is required for patients after TUVP and PKRP. Different therapeutic methods should be chosen according to different causes of the complications after operation.

关 键 词：前列腺增生 经尿道前列腺电汽化术 经尿道前列腺等离子电切术 随访研究 

分 类 号：R699.8[医药卫生—泌尿科学]