3种手术方法治疗高龄良性前列腺增生的效果及安全性比较  

Effects and Safety of Three Surgical Methods in the Treatment of Elderly Benign Prostatic Hyperplasia

作　　者：张超 ZHANG Chao(Department of Urology,Linying County People’s Hospital,Luohe 462600,China)

机构地区：[1]临颍县人民医院泌尿外科,河南漯河462600

出　　处：《河南医学研究》2021年第20期3720-3724,共5页Henan Medical Research

摘　　要：目的探讨经尿道前列腺电切除术(TURP)、经尿道前列腺剜除术(TUEP)、经尿道选择性绿激光前列腺汽化术(PVP)治疗高龄良性前列腺增生(BPH)患者的效果及安全性。方法回顾性分析2018年1月至2019年12月于临颍县人民医院接受治疗的161例高龄BPH患者的临床资料,根据手术方式分为TURP组(51例)、TUEP组(53例)和PVP组(57例)。TURP组接受TURP治疗,TUEP组接受TUEP治疗,PVP组接受PVP治疗。比较3组患者围手术期相关指标、术前及术后3个月尿动力学相关指标[最大尿流率(Q_(max))、残余尿量(PVR)、膀胱顺应性(BC)、最大逼尿肌压力(MDP)]、前列腺症状评分(IPSS评分)、生活质量(QOL),并记录术后并发症发生情况。结果PVP组术中出血量少于TURP组、TUEP组,PVP组手术时间、术后膀胱冲洗时间、术后导尿管留置时间、术后住院时间短于TURP组、TUEP组,差异有统计学意义(P<0.05);TUEP组术中出血量少于TURP组,术后膀胱冲洗时间、术后导尿管留置时间、术后住院时间短于TURP组,差异有统计学意义(P<0.05)。术后3个月,3组患者Q_(max)、BC较术前升高,PVR较术前减少,MDP、IPSS评分、QOL评分较术前下降,差异有统计学意义(P<0.05);3组间比较,差异无统计学意义(P>0.05)。3组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论TURP、TUEP、PVP均对高龄BPH患者有良好的治疗效果,且安全性可靠。TURP的手术时间长、术后并发症多,但预后较好;TUEP及PVP的术后并发症较少,PVP在缩短手术时间、促进患者康复方面有一定作用。临床治疗时,可根据患者实际情况选择最佳方案。Objective To explore the effects and safety of transurethral resection of the prostate(TURP),transurethral enucleation of the prostate(TUEP)and greenlight photoselective vaporization of prostate(PVP)in the treatment of elderly benign prostatic hyperplasia(BPH).Methods The clinical data of 161 elderly BPH patients admitted in Linying County People’s Hospital from January 2018 to December 2019 were Retrospectively analyzed.According to surgical methods,161 elderly BPH patients were divided into TURP group(51 cases),TUEP group(53 cases)and PVP group(57 cases).TURP group received TURP treatment,TUEP group received TUEP treatment,PVP group received PVP treatment.The perioperative related indicators,urodynamic related indicators[maximum urinary flow rate(Q_(max)),post-voiding residual(PVR),bladder compliance(BC),maximum detrusor pressure(MDP)],international prostate symptom score(IPSS)and quality of life(QOL)score before and 3 months after surgery were compared among the three groups.The occurrence of postoperative complications were recorded.Results The intraoperative blood loss in PVP group was less than that in TURP group and TUEP group,the surgical time,postoperative bladder irrigation time,postoperative catheter retention time and postoperative hospital stay were shorter than those in TURP group and TUEP group(P<0.05).The intraoperative blood loss in TUEP group was less than that in TURP group,the postoperative bladder irrigation time,postoperative catheter retention time and postoperative hospital stay were shorter than those in TURP group(P<0.05).And 3 months after surgery,the Q_(max) and BC were higher than those before surgery,PVR was less than that before surgery,MDP,IPSS score and QOL score were lower than those before surgery.(P<0.05),but there were no statistically significant differences among the three groups(P>0.05).There were no statistically significant differences in the incidence rates of postoperative complications among the three groups(P>0.05).Conclusion The treatment effect of TURP,TUEP and PV

关 键 词：良性前列腺增生 经尿道前列腺电切除术 经尿道前列腺剜除术 经尿道选择性绿激光前列腺汽化术 高龄 安全性 

分 类 号：R697.32[医药卫生—泌尿科学]