经直肠高强度聚焦超声与经尿道手术治疗良性前列腺增生的对比研究  

A comparative study of TUVRP, PKRP and transrectal high intensity focused ultrasound for the treatment of benign prostatic hyperplasia：a retrospective analysis

作　　者：黄福[1,2] 胡卫列[2] 吕军[2] 聂海波[2] 王元利[2] 张利朝[2] 赵永斌[2] 肖戈[2] 徐文清[2] 吴浩明[2] 

机构地区：[1]南方医科大学研究生院,广州510515 [2]广州军区广州总医院泌尿外科

出　　处：《中国男科学杂志》2013年第3期42-47,共6页Chinese Journal of Andrology

摘　　要：目的对比经尿道前列腺汽化电切术（Transurethral Vaporization Resection of the Prostate, TUVRP）、经尿道前列腺等离子体双极电切术（Bipolar Plasmakinetic Transurethral Resection of Prostate, PKRP）以及经直肠高强度聚焦超声（Transrectal High-intensity Focused Ultrasound, HIFU）前列腺消融术治疗前列腺增生症（benign prostatic hyperplasia,BPH）的临床疗效.方法将471例前列腺增生患者按术式不同分为三组,其中TUVRP组102例,PKRP组225例,HIFI组144例,回顾分析并比较各组术后一般情况及并发症等,并对相关指标进行统计学分析.结果3组病人术前一般情况比较无统计学差异（P〉0.05）.HIFU组的术后相关指标及并发症与TUVRP组和PKRP组差异有显著性（P0.05）.各组术后主、客观症状均较术前明显改善,差异有统计学意义（P〈0.05）.而HIFU组术后3个月时与术后2年时的主、客观指标比较,发现两者有显著性差异（P〈0.05）,术后2年较术后3个月主、客观症状进一步改善,但较TUVRP组和PKRP组的效果差.结论 TUVRP、PKRP和HIFU均是治疗BPH的有效方法, TUVRP与PKRP两者疗效相似,但PKRP的安全性较TUVRP高.相对而言,经直肠HIFU前列腺消融术是三者中治疗BP H最安全、痛苦最小、恢复最快、并发症最少的方法,缺点是有效性不如另外两种术式.Objective To comparatively analze the clinical efficacy of transurethral vaporization resection of the prostate （TUVRP）, bipolar plasmakinetic transurethral resection of prostate （PKRP） and high intensity focused ultrasound（HIFI） in the treatment of benign prostatic hyperplasia. Methods Based on different operation modes , 471 cases of BPH were divided into three groups such as TUVRP group（n=102）, PKRPgroup（n=225）, HIFUgroup （n=144）. And the therapeutic effects were evaluated. Results There was no significant differences in pretherapy parameters among three groups （P〉0.05）. HIFI group was different from TUVRP and PKRP group in post-operative complication and related indicator. （P0.05） Qmax, RUV, PV, IPSS, QOL were significantly improved in each group after the procedure（P〈0.05）. The subjective and objective symptoms further improved after 2 years in HIFI group,but was still lower than that of TUVRP and PKRP group. Conclusion All three methods are effective for treatment of BPH. TUVRP was similar to PKRP in efficacy,but the security of PKRP was higher than that of TUVRP. Generaly,security of transrectal high intensity focused ultrasound for treatment of BPH was better than that of TUVRP and PKRP group.

关 键 词：前列腺增生 经尿道前列腺切除术 

分 类 号：R697.32[医药卫生—泌尿科学]