PVP、等离子电切和PVP联合等离子治疗大体积BPH的疗效比较  

Comparison of Transurethral Photoselective Vaporization of Prostate,Transurethral Plasmakinetic Resection of Prostate and Photoselective Vaporization Plus Transurethral Plasmakinetic Resection in the Treatment of Large Benign Prostatic Hyperplasia

作　　者：农绍军[1] 马利民[1] 张跃平[1] 李文光[1] 管杨波[1] 周树军[1] 成兵[1] NONG Shao-jun;MA Li-min;ZHANG Yue-ping;LI Wen-guang;GUAN Yang-bo;ZHOU Shu-jun;CHENG Bin(Department of Urology,the Affiliated Hospital of Nantong University,Nantong,Jiangsu,226001,China)

机构地区：[1]南通大学附属医院泌尿外科,江苏南通226001

出　　处：《中国血液流变学杂志》2019年第4期446-449,共4页Chinese Journal of Hemorheology

基　　金：江苏省博士后课题(139951)。

摘　　要：目的比较经尿道绿激光汽化术(PVP)、经尿道等离子前列腺电切术(TUPKRP)和PVP联合TUPKRP治疗不同体积前列腺增生(BPH)的临床疗效.方法将体积大于80 mL的BPH患者90例,随机分为3组:PVP组(n=30),TUPKRP组(n=30),PVP+TUPKRP组(n=30),观察患者的手术情况、疗效、近期并发症.结果所有患者术后IPSS评分、QOL评分、Qmax、PVR较术前均有显著改善,三组间差异无统计学意义(P>0.05).PVP+TUPKRP组手术时间、留置尿管时间、术后住院时间、术中出血量及术后血钠浓度下降程度均明显少于PVP组及TUPKRP组.而PVP组和TUPKRP组差异无统计学意义(P>0.05).并发症方面,PVP+TUPKRP组短暂性尿失禁及继发性出血的发生率明显低于其余两组(P<0.05).结论PVP+TUPKRP组较PVP组、TUPKRP组具有出血更少、创伤更小、并发症发生率较低的优点,更适用于大于80 mL的BPH患者.Objective To study the efficacy and safety of transurethral photoselective vaporization of prostate(PVP),transurethral plasmakinetic resection of prostate(TUPKRP)and photoselective vaporization plus transurethral plasmakinetic resection for the treatment of large benign prostatic hyperplasia(BPH).Methods 90 patients with prostate hyperplasia larger than 80 mL were randomized to PVP group,TUPKRP group and PVP+TUPKRP group.Operative outcome,therapeutic efficacy and complications were compared.Results The postoperation in international prostate symptom score(IPPS),quality of life questionnaire(QOL),maximum flow rates(Qmax),postvoid urine residues(PVR)compared with pre-operation were better in three groups(P>0.05).The operation time,indwelling catheter time,postoperative hospital stay,intraoperative bleeding volume and postoperative degree of decrease of blood sodium concentration in the PVP+TUPKRP group were significantly less than those in PVP group and TUPKRP group(P<0.05).However,there was no significant difference between TUPKRP group and PVP group.There was less transient incontinence and postoperative blood loss in PVP+TUPKRP group compared with TUPKRP group and PVP group(P<0.05).Conclusion Compared with PVP and TUPKRP,there was less complication and blood loss in PVP+TUPKRP for treatment in large prostate hyperplasia.

关 键 词：前列腺增生 经尿道等离子前列腺电切术 绿激光前列腺汽化切除术 

分 类 号：R697.32[医药卫生—泌尿科学]