经尿道前列腺电切术与经尿道双极等离子电切术治疗良性前列腺增生比较分析及安全性评价  

Comparison and safety evaluation of transurethral resection of prostate versus bipolar plasmakinetic resection of the prostate in the treatment of benign prostatic hyperplasia

作　　者：肖伟[1] 杨科[1] 高智勇[1] 吴万瑞[1] 袁武雄[1] 周强[1] 段义星[1] 

机构地区：[1]湖南省人民医院泌尿外科,长沙410005

出　　处：《重庆医科大学学报》2014年第1期76-79,共4页Journal of Chongqing Medical University

摘　　要：目的 :探讨经尿道前列腺电切术(transurethral resection of prostate,TURP)与经尿道双极等离子电切术(bipolar plasmakinetic resection of the prostate,PKRP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)疗效、并发症及安全性差异。方法:收集2009年1月至2011年12月接受TURP和PKRP的BPH患者560例,其中TURP组210例,PKRP组350例,比较2组基线资料、疗效、并发症及安全性差异。结果:PKRP组与PKRP组比较,2组基线资料差异无统计学意义(P>0.05);PKRP组手术时间(t=8.046,P=0.000)、术中出血量(t=16.653,P=0.000)、留置尿管时间(t=7.701,P=0.000)均少于TURP组;TURP组术后较术前:国际前列腺症状评分(international prostate symptom score,IPSS)(t=62.092,P=0.000)、生活质量指数(quality of life,QOL)(t=72.355,P=0.000)、最大尿流率(maximum flow rate,Qmax)(t=73.993,P=0.000)均有改善,PKRP组术后较术前:IPSS(t=77.777,P=0.000)、QOL(t=82.038,P=0.000)、Qmax(t=89.860,P=0.000),均有明显改善,但2组间比较差异无统计学意义(P>0.05);TURP组前列腺电切综合征、血流动力学波动、术中大出血等13项发生率明显高于PKRP组(P<0.05)。结论:TURP和PKRP均为BPH的有效治疗手段。PKRP比较TURP,具有手术时间短、出血量少、并发症少、安全性更高等优点,但其长期疗效需进一步随访观察。Objective：To investigate the differences in clinical efficacy,complication and safety between transurethral resection ofprostate （TURP） and bipolar plasmakinetic resection of the prostate（PKRP） in the treatment of benign prostatic hyperplasia （BPH）. Methods：Totally 560 cases of BPH from January 2009 to December 2011 were divided into TURP group and PKRP group. General conditions, operation conditions, clinical efficacy and complications of two groups were analyzed. Results：There was no significant difference in baseline data between the two groups（P〉 0.05）. Operative time（t=8.046,P=-0.000） ,intraoperative bleeding（t=16.653 ,P=-0.000） and time of urethral catheterization（t=7.701 ,P=- 0.000） of PKRP group were significantly less than those TURP group（P〈0.05）. International prostate symptom score（IPSS）（t=62.092, P=0.000）, quality of life （QOL） （t=72.355 ,P=0.000）, maximum flow rate （Qmax） （t=73.993 ,P=0.000） were significantly improved in TURP group after surgery compared with those before surgery （P〈0.05）. IPSS （t=77.777,P=0.000）, QOL （t=82.038,P=0.000）, Qmax （t= 89.860,P=-0.000） were significantly improved in PKRP group after surgery compared with those before surgery（P〈0.05）,but there was no significant difference in above indicators between the two groups（P〉0.05）. Transurethral resection syndrome （TURS）, hemodynamic fluctuations,intraoperative blood loss etc were significantly higher in TURP group than in PKRP group（P〈0.05）. Conclusions：PKRP and TURP have similar clinical efficacy in the treatment of BPH. PKRP has advantages in shorter operative time,less bleeding and few complications in the treatment of BPH,but long-term therapeutic effect of PKRP needs further follow-up.

关 键 词：经尿道前列腺电切术 经尿道等离子电切术 良性前列腺增生 电切综合征 

分 类 号：R699.6[医药卫生—泌尿科学]