经尿道等离子前列腺剜除术治疗经直肠穿刺后良性前列腺增生患者的临床研究  

Clinical study on transurethral plasmakinetic enucleation of prostate in the treatment of benign prostate hyperplasia diagnosed by transrectai biopsy of prostate

作　　者：王晓明[1] 刘春雨[1] 高靖达 孙光[1] 徐勇[1] 

机构地区：[1]天津医科大学第二医院泌尿外科天津市泌尿外科研究所,300010

出　　处：《中华老年医学杂志》2016年第9期971-974,共4页Chinese Journal of Geriatrics

摘　　要：目的研究经尿道等离子前列腺剜除术（PKEP）治疗经直肠前列腺穿刺活检（TRPB）后良性前列腺增生（BPH）患者的有效性和安全性。方法回顾性分析2012年1月至2015年5月在天津医科大学第二医院行PKEP手术治疗的BPH患者88例，并进行随访。TRPB组38例患者术前均行TRPB，随机选取同期PKEP术前未行TRPB的50例BPH患者为NTRPB组。比较两组患者的基线资料，围术期相关参数及术后随访资料。结果88例患者平均年龄69．7岁。与NTRPB组比较，TRPB组患者年龄较小（t=2．62，P〈0．05），血前列腺特异抗原（PSA）水平较高（t=13．64，P〈0．01）。TRPB组较NTRPB组手术时间延长，（93．6±31．0）min比（77．9±17．3）min（t=2．64，P〈0．05），两组术中出血量、术后持续膀胱冲洗时间及留置尿管时间比较差异无统计学意义（均P〉0．05）。TRPB与PKEP间隔〉4周可缩短手术时间（P〈0．01），但术中出血量差异无统计学意义（P〉0．05）。两组均无输血、经尿道电切综合征、膀胱损伤、直肠损伤等情况。术后3、6、12个月随访结果均提示两组患者最大尿流率（Qmax）、国际前列腺症状评分（IPSS）评分及生活质量评分（QOL）评分差异无统计学意义（均P〉0．05）。结论PKEP治疗TRPB后BPH患者具有可行性及安全性，TRPB后4周以上再行PKEP手术可降低手术操作难度，提高安全性。Objective To evaluate the efficiency and safety of transurethral plasmakinetic enucleation of prostate（ PKEP） in the treatment of patients with benign prostate hyperplasia（BPH） after transrectal prostate biopsy（TRPB）. Methods A total of 88 BPH patients who underwent PKEP in our hospital during Jan. 2012 to May 2015 were retrospectively analyzed and followed- up. 38 patients underwent TRPB before PKEP were defined as TRPB group, and 50 patients underwent PKEP with no TRPB were defined as control group. The baseline data, perioperative data and postoperative follow-up outcomes were recorded and compared between the two groups. Results The mean age of the 88 patients were 69. 7 years. Compared with control group, TRPB group showed that age was younger（t= 2. 62, P〈 0. 05）and prostate specific antigen（PSA） level was higher（t= 13. 64,P〈0. 01）. Operation duration was longer in TRPB group than in control group（93.6±31.0）rain vs. （77.9±17.3）min（t=2.64,P〈0.05）. There were no significant differences in the preoperative data, blood loss, continuous bladder irrigation duration after operation and period of catheterization between two groups （all P 〉 0.05）. Trans-operative time was significantly shortened when the time interval between TRPB and PKEP is more than 4 weeks（P〈 0.01） ,while blood loss was similar in the two groups（P〈0.05）. There were no adverse events of blood transfusion, transurethral resection syndrome and injury of bladder or rectal in both two groups. There were no significant differences in maximum flow rate（ Qmax）, international prostate symptom score（IPSS） or quality of life（QOL） scores between the two groups at 3,6 and 12 monthsof follow up（all P〉0. 05）. Conclusions PKEP after TRPB is a safe and effective treatment forBPH patient. When the time interval between TRPB and PKEP is more than 4 weeks, theperforming of PKEP operation would reduce the difficulty of operative procedure and increase the safety.

关 键 词：前列腺增生 经尿道前列腺切除术 活组织检查 针吸 

分 类 号：R699.8[医药卫生—泌尿科学]