分区腺剜除术与双极等离子前列腺电切术治疗前列腺增生效果的比较研究  

Efficacy of transurethral enucleation of prostate and transurethral resection of prostate in treating patients with benign prostatic hyperplasia

作　　者：张常银[1] 陈静辉[1] 陶众杰 祁小龙[2] ZHANG Changyin;CHEN Jinghui;TAO Zhongjie;QI Xiaolong(Department of Urology Surgery,Pinghu Traditional Chinese Medicine Hospital,Jiaxing 314200,Zhejiang,China;Department of Urology Surgery,Zhejiang Provincial People＇ s Hospital,Hangzhou 310014,Zhejiang,China)

机构地区：[1]平湖市中医院泌尿外科,浙江嘉兴314200 [2]浙江省人民医院泌尿外科,杭州310014

出　　处：《中国性科学》2018年第6期11-14,共4页Chinese Journal of Human Sexuality

基　　金：浙江省平湖市科技计划项目(2016053)

摘　　要：目的:探讨经尿道前列分区腺剜除术(transurethral enucleation of prostate,TUEP)与经尿道双极等离子前列腺电切术(transurethral resectionprostatic,TURP)在治疗前列腺增生症的安全性和有效性,从而指导临床选择合适的手术方案。方法:选取2014年1月至2016年6月在平湖市中医院泌尿外科住院治疗的前列腺增生患者113例为研究对象,按照随机数字表法将其分为观察组57例、对照组56例。观察组患者行尿道前列分区腺剜除术,对照组患者行尿道前列腺电切术,记录并比较两组患者的术前及术后基本情况、国际前列腺症状评分(IPSS)、残余尿量(PVR)、生活质量(QOL)、最大尿流率(Qmax)等。结果:两组患者术前基本情况、IPSS、PVR、QOL、Qmax比较,差异无统计学意义(P>0.05)。观察组患者手术时间和术中出血量分别为(45.35±10.50)min、(112.40±50.45)ml,比对照组患者的(56.38±15.50)min、(207.85±78.80)ml明显降低,差异具有统计学意义(P<0.05)。观察组患者腺体切除率为(65.57±15.50)g,多于对照组患者的(48.54±12.45)g,差异具有统计学意义(P<0.05)。观察组患者术后住院时间、膀胱持续冲洗时间、并发症发生等均比对照组患者明显减少,其差异均有统计学意义(均P<0.05)。术后两组患者IPSS、PVR、QOL、Qmax比较,差异无统计学意义(P>0.05)。结论:在治疗前列腺增生症中,尿道前列分区腺剜除术比尿道双极等离子前列腺电切术有出血量少、手术时间短、术后并发症发生率低等优点。Objective： To investigate the safety and efficacy of transurethral enucleation of prostate（ TUEP） and transurethral resection prostatic（ TURP） in the treatment of patients with benign prostatic hyperplasia（ BPH）,to guide the clinical selection of appropriate surgical program. Methods： 113 patients with BPH from January 2014 to June 2016 were divided into observation group（ 57 cases） and control group（ 56 cases） according to the random number table method. The patients in the observation group underwent TUEP and patients in the control group underwent TURP. The preoperative and postoperative conditions of the two groups were recorded and compared. The international prostate symptom score（ IPSS）,residual urine volume（ PVR）,quality of life（ QOL）,maximum urinary flow rate（ Qmax）. Results： Differences in the preoperative basic situation,IPSS,PVR,QOL and Qmax were not significant between the two groups（ P 〉 0. 05）. The operation time and intraoperative blood loss in the observation group were（ 45. 35 ± 10. 50） min and（ 112. 40 ± 50. 45） ml respectively,significantly lower than those of the control group,which were（ 56. 38 ± 15. 50） min and（ 207. 85 ± 78. 80） ml accordingly,with statistically significant differences（ P 〈 0. 05）. The gland resection rate in the observation group and control group was（ 65. 57 ± 15. 50） % and（ 48. 54 ± 12. 45） % respectively,with statistically significant difference（ P 〈 0. 05）.The postoperative hospitalization time,bladder flushing time and incidence of complications in the observation group were obviously reduced compared with the control group,with statistically significant difference（ all P 〈 0. 05）. No significant difference was found in postoperative IPSS,PVR,QOL,Qmax between the two groups（ P 〉 0. 05）.Conclusions： In the treatment of BPH,TUEP has the advantages of less blood loss,short operation time,low inci-dence of postoperative complications,compared with TURP.

关 键 词：尿道前列分区腺剜除术 双极等离子前列腺电切术 前列腺增生症 

分 类 号：R699.8[医药卫生—泌尿科学]