经尿道等离子双极电切与改良Madigan术治疗不同体积BPH对比分析  

A comparative analysis of bipolar transurethral resection and modified madigan prostatectomy in different prostate volumes of benign prostatic hyperplasia

作　　者：徐国飚 

机构地区：[1]安徽省庐江县中医院泌尿外科,安徽庐江231500

出　　处：《安徽医药》2014年第4期673-676,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的比较经尿道等离子双极电切术(PKRP)及改良Madigan术治疗不同体积前列腺增生(BPH)的疗效与安全性。方法100例体积介于32~128 mL BPH患者被随机分入等离子组(PKRP)50例和改良Madigan组50例,进行疗效和安全性比较分析。结果两组患者术后IPSS、QOL、Q_(max)均较术前有明显改变(P<0.05),术后两组血清钠(Na^+)无明显变化。在前列腺体积<40 mL,40~80 mL时PKRP组术后膀胱冲洗时间,术后留置导尿管时间小于改良Madigan组(P<0.05)。当前列腺体积>80 mL时两组术后膀胱冲洗时间,术后留置导尿管时间比较差异无统计学意义(P>0.05)。术中出血量PKRP组小于改良Madigan组并且随前列腺体积增加两组差异明显减小,当腺体>80 mL时术中出血量两组间无差异(P>0.05)。在前列腺体积<40 mL手术时间PKRP组明显小于改良Madigan组(P<0.05)。前列腺体积位于40~80 mL时两组手术时间无明显差异(P>0.05)。当前列腺体积>80 mL时PKR组手术时间明显高于改良Madigan组(P<0.05)。术后尿失禁,尿道狭窄等并发症PKRP组高于改良Madigan组。结论 PKRP是一种安全有效的治疗方式,腺体体积在80 mL以下的BPH比改良Madigan有明显的微创优势,术后也能达到改良Madigan相同手术效果。在大体积腺体(>80 mL),虽然手术时间有所延长,但其术中出血少、创伤小仍有一定的优势。Objective To compare the efficacy and safety of bipolar plasmakinetic resection of the prostate （PKRP） and modified madigan prostatectomy in the treatment of benign prostatic hyperplasia （BPH） with different prostate volumes. Methods A hundred cases of BPH patients with prostate volume 32 - 128 mL were randomly assigned to plasma group （PKRP）and modified Madigan group to compare the efficacy and safety of them. Each group had 50 patients. Results The postoperative IPSS, QOL, Qmax changed significantly when compared with preoperative（P 〈 0. 05 ）. Postoperative serum sodium （Na^＋） had no statistically significant change in the two groups. In prostate volume 〈 40 mL, postoperative bladder irrigation time and postoperative catheter indwelling time for 40 - 80 mL was significantly shorter in PKRP group than modified Madigan prostatectomy group（ P 〈 0.05 ）. The intraoperative blood loss for PKRP is lesser than the Modified Madigan prostatectomy group, however as the prostate volume increased, the difference between the two groups decreased. For prostate volume 〉 80 mL, the intraoperative blood loss had no difference between the two groups （P 〉 0.05 ）. For prostate volume 〈 40 mL, PKRP group had a significantly shorter operation duration than the modified Madigan group （ P 〈0. 05 ）, whereas for prostate volume at 40 - 80 mL, operation time for the two groups had no significant difference （P 〉 0.05 ）. When prostate volume 〉 80 mL, the operation time for PKRP group was significantly longer than the modified Madigan group （ P 〈 0.05 ）. The occurrence of incontinence, urethral stricture and other complications is more significant in PKRP group than modified Madigan group. Conclusions PKRP is a safe and effective treatment which has an obvious advantage over Modified Madigan prostatectomy for being minimally invasive in gland volume 80 mL or less. The surgery can also achieve the same outcome as the Modified Madigan. Although the operation time is lengthened for l

关 键 词：良性前列腺增生症 不同体积前列腺 经尿道等离子双极电切术 改良MADIGAN术 

分 类 号：R699[医药卫生—泌尿科学]