PVP与TUPKRP治疗大体积前列腺增生的临床效果对比及术后性功能低下危险因素研究  

Comparison of clinical effects of PVP and TUPKRP in the treatment of large volume benign prostatic hyperplasia and risk factors of postoperative sexual dysfunction

作　　者：童占表 胡森[1] 王继贤 TONG Zhanbiao;HU Sen;WANG Jixian(Department of Urology,Qinghai Red Cross Hospital,Xining 810000,Qinghai,China)

机构地区：[1]青海红十字医院泌尿外科,西宁810000

出　　处：《中国性科学》2021年第5期34-37,共4页Chinese Journal of Human Sexuality

摘　　要：目的比较经尿道选择性绿激光前列腺汽化术(PVP)与经尿道等离子体双极电切术(TUPKRP)治疗大体积前列腺增生的临床效果,并分析术后性功能低下的危险因素。方法选取2016年7月至2019年7月青海红十字医院收治的102例大体积前列腺增生患者作为研究对象。根据手术方式分成PVP组(采用PVP,n=52)、TUPKRP组(采用TURPKRP,n=50)。比较两组围手术期指标,包括手术时间、导尿管留置时间、术中出血量、前列腺切除量、膀胱冲洗时间、冲洗液使用剂量、住院时间。分别在术前、术后3个月检测两组最大尿流率(Qmax)、残余尿量(PVR)、国际前列腺症状评分法(IPSS)评分,并比较两组性功能情况。采用Logistic回归模型分析患者术后性功能低下的危险因素。结果 PVP组导尿管留置时间、膀胱冲洗时间、住院时间显著短于TUPKRP组,差异具有统计学意义(P<0.05);PVP组术中出血量、冲洗液使用剂量显著少于TUPKRP组,差异具有统计学意义(P<0.05);两组术后3个月的Qmax显著高于术前,PVR以及IPSS评分显著低于术前,差异具有统计学意义(P<0.05);两组术前、术后3个月的Qmax、PVR以及IPSS评分比较,差异无统计学意义(P>0.05);两组勃起情况以及逆行射精、射精疼痛发生率比较,差异无统计学意义(P>0.05);膀胱颈完整性受损、高温电切、年龄≥65岁是术后性功能低下的危险因素(P<0.05)。结论 PVP、TUPKRP均对大体积前列腺增生患者具有较好的治疗作用,其中PVP能缩短导尿管留置、膀胱冲洗以及住院时间,且术中出血量、冲洗液使用剂量减少,两种术式对性功能的影响接近,术后性功能低下主要与膀胱颈完整性、高温电切、患者年龄有关。Objective To investigate the clinical effect of greenlight photoselective vaporization of prostate(PVP) and transurethral bipolar plasma kinetic resection of the prostate(TUPKRP) in the treatment of large volume benign prostatic hyperplasia(BPH) and the risk factors of postoperative sexual dysfunction. Methods From July 2016 to July 2019, 102 patients with large vdume BPH were selected and divided into two groups according to the operation mode: selective PVP(PVP group, 52 cases) and TUPKRP(TUPKRP group, 50 cases).The perioperative indexes of the two groups were compared, including operation time, catheter retention time, intraoperative bleeding volume, prostatectomy volume, bladder washing time, washing liquid dosage and hospitalization time. Before and 3 months after the operation, the maximum urine flow rate(Qmax), residual urine volume(PVR) and International Prostate Symptom Score(IPSS) of the two groups were measured, and the sexual function of the two groups were compared. The risk factors of sexual dysfunction were analyzed by logistic regression model. Results The indwelling time of catheter, bladder washing time and hospitalization time in PVP group were significantly shorter than those in TUPKRP group(P<0.05). The amount of bleeding and the dosage of washing solution in PVP group were significantly lower than that in TUPKRP group(P<0.05). Three months after operation, Qmax of the two groups was significantly higher than that before operation, PVR and IPSS scores were significantly lower than that before operation(P<0.05).There was no significant difference in the scores of Qmax, PVR and IPSS between the two groups before and 3 months after operation(P>0.05). There was no significant difference between the two groups in the status of erection and the incidence of retrograde ejaculation and ejaculation pain(P>0.05). Impaired bladder neck integrity, high-temperature resection, and age ≥65 years are risk factors for postoperative sexual dysfunction(P<0.05). Conclusions Both PVP and TUPKRP have a good ther

关 键 词：大体积前列腺增生 经尿道选择性绿激光前列腺汽化术 经尿道等离子体双极电切术 性功能 危险因素 

分 类 号：R697[医药卫生—泌尿科学]