TUPKVP与SP治疗超过100g巨大前列腺增生的术中损伤与疗效的对比分析  

Comparison Analysis on Therapeutic Effect of Transurethral Bipolar Plasma Kinetic Vaporization Prostatectomy and Open Suprapubic Prostatectomy on Extracting Giant Benign Prostatic Hyperplasia Over 100g

作　　者：袁碧林 肖雄 吴登贵 古明聪 王凌飞 YUAN Bilin;XIAO Xiong;WU Denggui;GU Mingcong;FANG Lingfei(Department Two of Urinary Surgery,Wutongqiao District People＇s Hospital,Leshan 614000,China;Outpatient Clinic,Chinese PLA 93169 Hospital,Siping 136000,China)

机构地区：[1]五通桥区人民医院泌尿外二科 [2]解放军93169部队医院门诊所

出　　处：《医学综述》2018年第16期3316-3319,3328,共5页Medical Recapitulate

摘　　要：目的比较经尿道前列腺等离子双极汽化电切术(TUPKVP)与开放性耻骨上经膀胱前列腺切除术(SP)治疗超过100 g巨大前列腺增生的疗效。方法对2010年10月至2012年10月在五通桥区人民医院泌尿外科接受前列腺增生切除手术的患者进行病例筛选,共筛选得61例接受SP治疗的患者,59例接受TUPKVP治疗的患者,均为超过100 g的巨大前列腺增生,比较两组手术情况及术后改善情况。结果 TUPKVP组术中出血量显著少于SP组[(215±34)m L比(382±46)m L](P<0.05),尿管留置时间、膀胱冲洗时间、住院时间显著短于SP组[(4.3±0.5)d比(5.9±0.4)d,(1.5±0.4)d比(2.4±0.3)d,(5.9±0.5)d比(7.2±0.8)d](P<0.05)。国际前列腺症评分、排尿后残留指标均低于SP组[6(4~10)分比9(5~11)分,37(32~41)m L比52(38~59)m L],国际勃起功能指数和峰值流速指标高于均高于SP组[(18.5±5.9)分比(17.5±4.8)分,15(12~17)m L/s比12(10~14)m L/s](P<0.05)。结论与SP相比,TUPKVP治疗超过100 g的巨大前列腺增生具有手术时间短、术后恢复快、并发症发生率低、预后更加良好的优点,是一种更加安全、有效的治疗方式。Objective To compare the clinical efficacy of transurethral bipolar plasma kinetic vaporization prostatectomy（ TUPKVP） and open suprapubic prostatectomy（ SP） on extracting giant benign prostatic hyperplasia（ BPH） over 100 g.Methods Patients with benign prostatic hyperplasia in Department of Urinary Surgery of Wutongqiao District People＇ s Hospital were selected during Oct. 2010 and Oct. 2012. A total of 120 patients who underwent open SP（ n = 61） or TUPKVP（ n = 59） were inclu-ded,the BPH of which was all over 100 g. The operation and the postoperative improvement of the two groups were compared. Results The operative blood loss in the TUPKVP group was lower than that in the SP group[（ 215 ±34） m L vs（ 382 ± 46） m L]（ P〈0. 05）,and the indwelling catheter time,bladder irrigation time and hospitalization time in the TUPKVP group were less than those in the SP group[（ 4. 3 ± 0. 5） d vs（ 5. 9 ± 0. 4） d,（ 1. 5 ± 0. 4） d vs（ 2. 4 ± 0. 3） d,（ 5. 9 ± 0. 5） d vs（ 7. 2 ± 0. 8） d]（ P〈0. 05）. International prostate symptom score（ IPSS） and post-voiding residue（ PVR） of the TIPKP group were less than those in the SP group,and international index of erectile function-5（ IIEF-5） and PFR（ peak flow rate） of the TUPKVP group were higher than those in the SP group [6（ 4-10） vs 9（ 5-11）,37（ 32-41） m L vs 52（ 38-59） m L,（ 18. 5 ± 5. 9） vs（ 17. 5 ± 4. 8）,15（ 12-17） m L/s vs 12（ 10-14） m L/s]（ P〈0. 05）. Conclusion Compared with SP,TUPKVP is a safe and highly effective treatment modality for BPH over 100 g,with the advantages of shorter operation time,faster postoperative recovery,lower complication incidence and better progonosis.

关 键 词：超过100g前列腺增生 经尿道前列腺等离子双极汽化电切术 开放性耻骨上经膀胱前列腺切除术 

分 类 号：R697[医药卫生—泌尿科学]