三种术式治疗高龄高危前列腺增生症的疗效比较  

Comparative study of three surgical methods in the treatment of advanced age and high-risk patients with benign prostatic hyperplasia

作　　者：陈晓君 陈婧 叶木石 李卓 柳建军 CHEN Xiaojun;CHEN Jing;YE Mushi;LI Zhuo;LIU Jianjun(Department of Urology,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,China)

机构地区：[1]广东医科大学附属医院泌尿外科

出　　处：《实用医学杂志》2019年第23期3618-3623,共6页The Journal of Practical Medicine

基　　金：国家自然科学基金项目（编号：81272833）

摘　　要：目的探讨经尿道绿激光前列腺汽化术(photoselective vaporization of the prostate,PVP)、经尿道前列腺等离子剜除术(transurethra plasma kinetic enucleation of the prostate,PKEP)、经尿道前列腺等离子双极电切术(transurethra plasma kinetic resection of the prostate,PKRP)在高龄高危前列腺增生症(benign prostatic hyperplasia,BPH)患者中的应用价值。方法240例高龄高危BPH患者被随机分为A、B、C组,每组各80例。A、B、C组分别采用PVP、PKEP和PKRP进行治疗。比较3组患者的围手术期指标、应激反应指标、炎症因子浓度、并发症、国际前列腺症状评分、生活质量评分、最大尿流率和残余尿量。结果在手术时间、术中失血量、留置尿管时间、膀胱冲洗时间、术后住院时间方面,A组最优,B组次之,C组最差(P<0.05)。术后1 d的Cor、NE、E、FBG、IL-6、IL-2、IL-1β、TNF-α浓度以A组最低,B组次之,C组最高(P<0.05)。A组的短暂性尿失禁发生率明显低于B组(P<0.0125)。结论在围手术期指标、应激反应和全身炎症反应方面,PVP最优,PKEP次之,PKRP最差,但3中术式的近期效果无差别,其中PKEP的短暂性尿失禁发生率较高。Objective The aim of this study is to investigate the value of photoselective vaporization of the prostate(PVP),transurethra plasma kinetic resection of the prostate(PKEP)and transurethral plasma kinetic resection of the prostate(PKRP)in the treatment of advanced age and high-risk patients with benign prostatic hyperplasia(BPH).Methods A total of 240 advanced age and high-risk patients with BPH were randomized into groups A,B and C and 80 cases in each group.Group A,B and C was treated with PVP,PKEP and PKRP respectively.Perioperative indicators,stress response indicators,concentration of inflammatory factors,complications,international prostate symptom score,quality of life,maximum urinary flow rate and residual urine volume were compared among three groups.Results In terms of operation time,intraoperative blood loss,indwelling catheter time,bladder irrigation time and hospital stay after operation,group A was the superior,followed by group Band group C was the worst(P<0.05).The concentration of Cor,NE,E,FBG,IL-6,IL-2,IL-1 beta and TNF-αin 1 day after operation were the lowest in group A,followed by group B and group C(P<0.05).The transient urinary incontinence incidence of group A was significantly lower group B(P<0.0125).Conclusions In terms of perioperative indicators,stress reaction and systemic inflammatory reaction,PVP was the best,followed by PKEP and PKRP but the short-term effects of the three surgical methods were not different.The transient urinary incontinence incidence of PKEP was higher than others.

关 键 词：前列腺增生症 经尿道绿激光前列腺汽化术 经尿道前列腺等离子剜除术 经尿道前列腺等离子双极电切术 高龄 高危 应用价值 

分 类 号：R69[医药卫生—泌尿科学]