组织刨削器辅助下经尿道等离子体解剖性前列腺推剥术治疗良性前列腺增生临床效果的研究  

Clinical efficacy of morcellator assisted by transurethral bipolar plasmakinetic enucleation and resction of the prostate in the treatment of benign prostatic hyperplasia

作　　者：张庆鑫 殷晓蒙[1] 沈进[1] 郭爽[1] 于发琪 姜心[1] Zhang Qingxin;Yin Xiaomeng;Shen Jin;Guo Shuang;Yu Faqi;Jiang Xin(Department of Urology,Shenyang Fifth People′s Hospital,Shenyang 110000,China)

机构地区：[1]沈阳市第五人民医院泌尿外科,110000

出　　处：《国际外科学杂志》2021年第12期824-828,共5页International Journal of Surgery

基　　金：沈阳市卫健委科研立项(2020034)。

摘　　要：目的探讨组织刨削器辅助下行经尿道等离子体解剖性前列腺推剥术治疗良性前列腺增生的临床疗效。方法回顾性分析2020年4月—2021年4月沈阳市第五人民医院泌尿外科收治的90例良性前列腺增生患者的病例资料,根据手术方法不同将其分为两组:试验组(n=50)和对照组(n=40)。试验组患者行组织刨削器辅助下经尿道等离子体解剖性前列腺推剥术,对照组患者行等离子体前列腺切除术。比较两组患者的手术时间、术中出血量、术后尿管留置时间、住院时间、血红蛋白降低幅度、术后3个月的国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿量(PVR)以及手术并发症等相关指标。计量资料以均数±标准差(Mean±SD)表示,组间比较采用t检验;计数资料组间比较采用χ^(2)检验。结果两组患者均成功行经尿道手术治疗,试验组和对照组患者的术中出血量[(62.11±5.32)mL比(95.12±10.32)mL]、手术时间[(40.25±12.75)min比(72.1±13.41)min]、术后尿管留置时间[(3.02±0.41)d比(4.73±1.32)d]、住院时间[(4.03±0.41)d比(6.52±0.85)d]、血红蛋白降低幅度[(2.65±0.52)g/L比(4.21±0.85)g/L]比较,差异均具有统计学意义(P<0.05)。试验组和对照组患者术后3个月的IPSS[(7.36±3.26)分比(8.12±3.56)分]、QOL评分[(2.12±0.32)分比(2.32±0.21)分]、Qmax[(15.47±4.53)mL/s比(16.23±3.21)mL/s]、PVR[(15.25±5.14)mL比(16.21±5.26)mL]、并发症发生率(6.00%比5.00%)等指标比较,差异均无统计学意义(P>0.05)。结论组织刨削器辅助下行经尿道等离子体解剖性前列腺推剥术治疗良性前列腺增生是安全、可行的,能明显提高其临床疗效。Objective To explore the clinical efficacy of morcellator assisted by transurethral bipolar plasmakinetic enucleation and resction of the prostate in the treatment of benign prostatic hyperplasia.Methods A total of 90 patients with benign prostatic hyperplasia treated in the Department of Urology,Shenyang Fifth People′s Hospital from Apirl 2020 to Apirl 2021 were retrospectively analyzed.They were divided into the experimental group(n=50)and the control group(n=40)according to different sugical methods.Among them,patients underwent transurethral plasma anatomical prostatectomy with the aid of morcellator in the experimental group,patients of the control group underwent plasma prostatectomy.The operation time,intraoperative blood loss,the decrease in hemoglobin,postoperative catheter retention,hospitalization time,international prostate symptom score(IPSS)of 3 months after surgery,quality of life score(QOL),maximum urine flow rate(Qmax),residual urine volume(PVR),surgical complications and other related indicators in the two groups were compared.Measurement data were expressed as mean±standard deviation(Mean±SD),comparison between groups was by t-test;comparison of count data between groups was by Chi-square test.Results Both groups were successfully treated by transurethral surgery.There were significant difference in the amount of blood loss[(62.11±5.32)mL vs(95.12±10.32)mL],the total operation time[(40.25±12.75)min vs(72.1±13.41)min],postoperative catheter retention[(3.02±0.41)d vs(4.73±1.32)d],hospitalization time[(4.03±0.41)d vs(6.52±0.85)d],the decrease in hemoglobin[(2.65±0.52)g/L vs(4.21±0.85)g/L](P<0.05);there was no significant difference in the IPSS score(7.36±3.26 vs 8.12±3.56),QOL(2.12±0.32 vs 2.32±0.21),Qmax[(15.47±4.53)mL/s vs(16.23±3.21)mL/s],PVR[(15.25±5.14)mL vs(16.21±5.26)mL],the incidence of complications(6.00%vs 5.00%)(P>0.05).Conclusion It is safe and feasible to treat benign prostatic hyperplasia by transurethral plasma anatomical prostatectomy assisted by tissue planer

关 键 词：前列腺增生 经尿道前列腺切除术 刨削器 

分 类 号：R699.8[医药卫生—泌尿科学]