经尿道等离子前列腺剜除术与电切术治疗大体积前列腺增生疗效比较  

Clinical efficacy comparison of transurethral plasma kinetic enucleation of prostate and transurethral resection of prostate for benign prostatic hyperplasia with over 80 mL volume

作　　者：刘宏伟[1] 左玲[2] 柳建军[1] 黄兴端[1] 许志坚[1] 

机构地区：[1]广东医学院附属医院泌尿外科,湛江524001 [2]广东医学院第二附属医院中医科

出　　处：《中国男科学杂志》2015年第11期45-48,52,共5页Chinese Journal of Andrology

基　　金：广东医学院青年科研基金(XQ1112);广东医学院附属医院青年科研基金(2009K02)

摘　　要：目的探讨经尿道等离子前列腺剜除术（TPKEP）与经尿道前列腺电切术（TURP）治疗大体积（80mL以上）良性前列腺增生（BPH）的临床疗效。方法137例大体积BPH患者分成两组，61例行TPKEP，76例行TURP，比较两种手术方式的手术时间、留置导尿时间、膀胱冲洗时间、前列腺切除质量、血红蛋白降低指数、血钠降低指数、术中出血量、术后住院时间及并发症。并对两种手术方式术后6个月最大尿流率（Qmax）、国际前列腺症状评分（IPSS）、生活质量（QoL）评分、残余尿量（PVR）及前列腺特异抗原（PSA）的变化值进行比较。结果在手术时间、留置导尿时间、膀胱冲洗时间、术后住院时间、术中出血量、血红蛋白降低指数及血钠降低指数方面TPKEP组明显低于TURP组（t=10．956、-7．728、-6．126、-8．952、-3．055、-7．115、-2．966，P〈0．05），而前列腺切除质量TPKEP组明显高于TURP组（t=13．878，P〈0．05）；TPKEP组术后6个月Qmax增加程度和PSA下降程度均高于TURP组（f=4．357、3．379，P〈0．05）；TPKEP组泌尿系感染、二次出血、尿道狭窄发生率均低于TURP组（x2=4．133、4．354、4．165，P〈0．05），但假性尿失禁发生率高于TURP组（x2=6．436，P〈0．05）。结论与TURP相比，TPKEP对于大体积的BPH患者具有明显优势，是一种治疗80mL以上BPH安全有效的新方法，具有出血少、恢复快、住院时间短、安全性高等优点，值得临床推广。Objective To compare the clinical efficacy oftransurethral plasma kinetic enucleation ofprostate（TPKEP） and transurethral resection of prostate（TURP） for treatment of benign prostatic hyperplasia（BPH） with over 80 mL volume. Methods The surgical procedures of 137 BPH patients with over 80 mL volume were analyzed retrospectively. The operation time, intubation time, bladder irrigation time, resected tissue weight, drop in hemoglobin, drop in serum sodium, blood loss, postoperative hospitalization time, complications, and the postoperative 6 months change value of maximum urinary flow rate（Qmx）,intemational prostate symptom score（IPSS）, quality of life（QoL） score, postvoid residua （PVR）, prostate specific antigen（PSA） level of the two groups were comparatively analyzed. Results Sixty-one cases and 76 cases were performed by the methods of TPKEP and TURP, respectively. There was no significant difference in preoperative parameters between the two groups（P〉0.05）; The operation time, intubation time, bladder irrigation time blood loss, postoperative hospitalization time, drop in hemoglobin and drop in serum sodium were significant lower in TPKEP group than those in TURP group （t=-10.956, -7.728, 6.126, -8.952, -3.055, -7.115, -2.966, P〈0.05）.The resected tissue weight in TPKEP group was significantly higher than that in TURP group（t=-13.878, P〈0.05）; The increase of Qmax and the decline of PSA level in TPKEP group were higher than that in TURP group at postoperative 6 months（t=4.357, 3.379, P〈0.05）.The rate of urinary infection, secondary hemorrhage and urethral stricture for TPKEP were lower than that for TURP（x2=4.133,4.354,4.165, P〈0.05）, but the incidence of false incontinence for TPKEP were higher than that for TURP（x2=6.436,P〈0.05）. Conclusion TPKEP has obvious advantages over TURP for treatment of large volume of prostate patients in less bleeding, faster recovery, shorter hospitalization time and high safety, which can be considered for clinic

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]