体积>80mL的良性前列腺增生患者经尿道等离子前列腺电切术中应用尖部收切法的可行性与安全性分析  

Feasibility and Safety of Apical Inward Cut during Bipolar Transurethral Plasma Kinetic Prostatectomy on Patients with Benign Prostatic Hyperplasia with Volume>80 mL

作　　者：彭强[1] 王定勇[1] 田峰[1] 王魏龙 赵修民[1] PENG Qiang;WANG Dingyong;TIAN Feng(Mianyang People's Hospital,Sichuan Mianyang 621000,China)

机构地区：[1]四川省绵阳市人民医院泌尿外科,四川绵阳621000

出　　处：《河北医学》2024年第4期651-656,共6页Hebei Medicine

基　　金：四川省卫生和计划生育委员会科研课题(编号:18PJ457)。

摘　　要：目的:分析体积>80mL的良性前列腺增生(BPH)患者经尿道等离子前列腺电切术(TUP-KP)术中应用尖部收切法的可行性与安全性。方法:选取2019年10月至2022年10月196例我院体积>80mL、择期手术的BPH患者,随机分为两组,研究组(n=98,采用TUPKP术中应用尖部收切法),常规组(n=98,采用常规TUPKP术),比较两组患者手术相关指标、逼尿肌稳定性相关指标、前列腺症状、生活质量及并发症。结果:两组手术相关指标差异无统计学意义(P>0.05);术后3个月,两组患者逼尿肌压力、初始尿意容量、排尿后残尿量以及最大尿意容量各自较术前相比皆有所改善(P<0.05),但两组患者组间上述指标差值均无统计学意义(P>0.05);术后3个月,研究组国际前列腺症状评分等级优于常规组(P<0.05),且时间与前列腺症状分级的交互项具有显著性(P<0.05);术后3个月,两组患者生活质量评分量表各维度较术前均升高(P<0.05),研究组生活质量评分量表各维度差值均高于常规组(P<0.05);术后3个月,研究组总并发症发生率为2.04%,低于常规组的9.18%(P<0.05)。结论:TUPKP术中应用尖部收切法治疗体积>80mL的BPH患者可缓解症状,改善生活质量,且并发症少,安全可靠。Objective:To analyze the feasibility and safety of apical inward cut during transurethral plas-ma kinetic prostatectomy(TUPKP)on patients with benign prostatic hyperplasia(BPH)with volume>80mL.Methods:A total of 196 BPH patients with volume>80 mL and elective surgery in our hospital were selected from October 2019 to October 2022,and were randomly divided into two groups,the study group(n=98,with the application of apical retractive dissection during TUPKP)and the conventional group(n=98,with conventional TUPKP).The operation time,bleeding volume,weight of the resected gland,hospitalization time,forced urethral muscle pressure,initial urinary volume,residual urine volume after voiding,maximum urinary volume,International Prostate Symptom Score,Quality of Life Rating Scale,and complication rate were compared between the two groups.Results:The surgery-related indicators revealed no statistical differ-ences between the two groups(P>0.05).At 3 months after surgery,the detrusor pressure,initial urine vol-ume,residual urine volume after urination and maximum urine volume were improved in both groups compared with those before surgery(P<0.05),but the differences of above indicators between both groups were not sta-tistically significant(P>0.05).The international prostate symptom score grading in study group at 3 months after surgery was better in comparison with conventional group(P<0.05),and the interaction term between time and prostate symptom grading was significant(P<0.05).At 3 months after surgery,the scores of dimen-sions of quality of life scale were enhanced in both groups compared to before surgery(P<0.05),and the differences of scores of dimensions of quality of life scale were higher in study group compared to conventional group(P<0.05).The total incidence rate of complications in study group at 3 months after surgery was 2.04%,which was lower than 9.18%in conventional group(P<0.05).Conclusion:Apical inward cut during TUPKP can relieve the symptoms and enhance the quality of life in the treatment of patients

关 键 词：良性前列腺增生 经尿道等离子前列腺电切术 体积>80mL 尖部收切法 

分 类 号：R699.8[医药卫生—泌尿科学]