经尿道等离子电切与经膀胱前列腺摘除术治疗大体积前列腺增生的比较  

Comparison of transurethral plasmakinetic resection of the prostate and transvesical prostectomy for the treatment of large volume benign prostatic hyperplasia

作　　者：龙智[1] 何乐业[1] 钟狂飚[1] 汤育新[1] 黄凯[1] 张一川[1] 

机构地区：[1]中南大学湘雅三医院泌尿外科,长沙410013

出　　处：《临床泌尿外科杂志》2013年第1期46-50,共5页Journal of Clinical Urology

摘　　要：目的:比较经尿道前列腺等离子电切术(PKPR)和经膀胱前列腺摘除术(TVP)治疗大体积(100～150ml)良性前列腺增生(BPH)的安全性和有效性。方法:将100例体积介于100～150ml的BPH患者随机分配到PKRP组和TVP组。术前分析相关临床资料,术后1个月、3个月、6个月和12个月对患者进行随访,评估指标包括国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)和膀胱剩余尿量(PVR),并记录不良事件。结果:总计有96例患者完成了12个月的随访,PKRP组手术时间较长,但术中失血量少;TVP组虽然有较高的输血率,但腺体切除率占明显优势。PKRP组术后留置导尿管时间、膀胱冲洗时间及住院时间明显缩短。术后1个月,两组的评估指标均得到显著改善,下尿路症状的改善状态在术后12个月内均维持着稳定状态,两组间IPSS、QOL、Qmax和PVR参数并无明显差异。虽然术后两组的并发症发生率较少,但PKRP组的尿道狭窄发生率高于TVP组。结论:对于体积介于100～150ml的BPH患者,PKRP是一种安全有效的治疗方式,能达到传统开放手术的效果。Objective：To compare the safety and efficacy of transurethral plasmakinetic resection of the pros- tate（PKRP） and transvesieal prostectomy（TVP） for the treatment of large volume benign prostatic hyperplasia （BPH）. Method：Ninety-nine BPH patients with a 100-150 ml BPH were randomized into the PKRP and TVP groups. The relevant clinical data were reviewed preoperatively. Patients had follow-up appointments at one, three, six and 12 months postoperatively. The assessment indicators included the international prostate symptom score（IPSS）, the quality of life score（QOL）, the maximum uxinary flow rate（Qmax） and the post-void residual u- rine volume（PVR）. Adverse effects were also recorded. Result：A total of 96 patients completed the 12-month fol- low-up. The operative time was longer, but intraoPera^ive blood loss was lower in the PKRP group. Despite a higher blood transfusion rate, there was an obvious advantage in gland removal rate in the TVP group. The dura- tion of postoperative catheterization, bladder irrigation and hospital stay was significantly shorter in the PKRP group. Assessment indicators were significantly improved in both groups at One month postoperatively. The im- provement in lower urinary tract symptoms was maintained throughout the 12 months after surgery. There were no significant differences in IPSS, QOL, Qmax and PVR between the two groups. The PKRP group had a higher incidence of urethral stricture than the TVP group. Conclusion：PKRP is a safe and effective treatment method and can achieve the effects of traditional open surgery for the treatment of 100-150 ml BPH.

关 键 词：良性前列腺增生 大体积前列腺 经尿道前列腺等离子电切术 经膀胱前列腺摘除术 

分 类 号：R697[医药卫生—泌尿科学]