选择性与传统经尿道等离子前列腺切除术治疗高危良性前列腺增生的疗效比较  

A comparative study of selective TUPKP and traditional TUPKP in the treatment of benign prostatic hyperplasia at high risk

作　　者：李树人 李文泽 杨杰 汪家兴 何坚 蒋庆详 周朝阳 黎礼元 LI Shuren;LI Wenze;YANG Jie;WANG Jiaxing;HE Jian;JIANG Qingxiang;ZHOU Zhaoyang;LI Liyuan(Department of Urology,Nanhua University Affiliated Xiangtan Hospital,Xiangtan,Hunan 411101,China)

机构地区：[1]南华大学附属湘潭医院泌尿外科,湖南湘潭411101

出　　处：《安徽医药》2022年第2期278-281,共4页Anhui Medical and Pharmaceutical Journal

基　　金：湖南省卫生健康委员会科研计划课题(C2016114)。

摘　　要：目的比较选择性经尿道等离子前列腺切除术(s-TUPKP)与传统经尿道等离子前列腺切除术(TUPKP)治疗膀胱内前列腺突出度(IPP)≥10 mm高危良性前列腺增生(BPH)的临床疗效及安全性。方法回顾性分析2016年6月至2019年3月南华大学附属湘潭医院收治的188例IPP≥10 mm高危BPH病人,其中采用选择性TUPKP为观察组92例,采用传统TUPKP为对照组96例,比较两组手术时间、术中出血量、切除组织量、术后并发症等指标,对比手术安全性;比较两组术前及术后6个月的最大尿流率(Qmax)、残余尿(RUV)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、IPP,对比其临床疗效。结果观察组与对照组手术时间分别为(33.1±7.7)min、(63.7±14.3)min,术中出血量分别为(75.6±19.0)mL、(100.1±23.0)mL,切除组织质量分别为(23.02±4.17)g、(47.10±9.58)g,组间比较均差异有统计学意义(P<0.05)。术后随访6个月,两组Qmax均较术前明显增加,术后IPSS、QOL、RUV、IPP均较术前明显下降,差异有统计学意义(P<0.05);两组术后感染、出血、短暂性尿失禁、尿道狭窄比较均差异无统计学意义(P>0.05)。结论选择性TUPKP与传统TUPKP两种手术方式治疗BPH均有明显临床疗效,但选择性TUPKP平均手术时间较短,术中出血量较少,尤其对于IPP≥10 mm高危BPH病人具有更高的安全性。Objective To compare the clinical efficacy and safety between selective transurethral plasma prostatectomy(s-TUPKP)and traditional transurethral plasma prostatectomy(TUPKP)in the treatment of benign prostatic hyperplasia(BPH)with a high risk of 10 mm intravesical prostatic protrusion(IPP).Methods A retrospective analysis was performed on 188 cases of BPH with high risk of 10 mm IPP treated in Nanhua University Affiliated Xiangtan Hospital from June 2016 to March 2019,including 92 patients treated with selective TUPKP as observation group and 96 patients treated with traditional TUPKP as control group.The operation time,intraoperative blood loss,excised tissue and postoperative complications were compared between the two groups in order to compare the safety of operation.The maximal flow rate(Qmax),residual urine(RUV),international prostate symptom score(IPSS),,quality of life(QOL)and IPP were compared before and 6 months after operation.Results The operative time of the observation group and the control group was(33.1±7.7)min and(63.7±14.3)min,the intraoperative blood loss was(75.6±19.0)mL and(100.1±23.0)mL,the resected tissue mass was(23.02±4.17)g and(47.10±9.58)g,respectively.There were statistically significant differences between the two groups(P<0.05).After 6 months follow-up,Qmax in both groups were significantly increased,IPSS,QOL,RUV and IPP were significantly decreased(P<0.05)There was no significant difference in postoperative infection,bleeding,transient urinary incontinence and urethral stricture between the two groups(P>0.05).Conclusion Both selective TUPKP and traditional TUPKP have significant clinical effects on BPH,but selective TUPKP has shorter operation time and less intraoperative blood loss,especially for patients with high risk of IPP 10 mm.

关 键 词：前列腺增生 经尿道前列腺切除术 膀胱内前列腺突出度 

分 类 号：R699.8[医药卫生—泌尿科学]