经尿道前列腺等离子双极电切术治疗高危良性前列腺增生患者的多中心、前瞻性研究  

Transurethral plasmakinetic resection of prostate in high-risk benign prostatic hyperplasia patients:a multicenter prospective study

作　　者：李飞[1,2] 耿杰 陈洪波[4] 周治军 刘孝华[6] 石洪波 杜丹[8] 朱涛 张景宇[10] 李晓东 却辉 宋洪飞 姚启盛[14] 窦中岭[15] 阮建中[16] 郑江 祝子清[18] 任选义 黄桥 龚侃 刘同族[1] 贺大林[21] 曾宪涛[1,2] LI Fei;GENG Jie;CHEN Hongbo;ZHOU Zhijun;LIU Xiaohua;SHI Hongbo;DU Dan;ZHU Tao;ZHANG Jingyu;LI Xiaodong;QUE Hui;SONG Hongfei;YAO Qisheng;DOU Zhongling;RUAN Jianzhong;ZHENG Jiang;ZHU Ziqing;REN Xuanyi;HUANG Qiao;GONG Kan;LIU Tongzu;HE Dalin;ZENG Xiantao(Department of Urology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Center for Evidence-Based and Translational Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Urology,Suizhou Central Hospital,Suizhou 441300,Hubei Province,China;Department of Urology,The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi Tujia and Miao Autonomous Prefecture 445000,Hubei Province,China;Department of Urology,The First People’s Hospital of Tianmen in Hubei Province,Tianmen 431700,Hubei Province,China;Department of Urology,Minda Hospital of Hubei Minzu University,Enshi Tujia and Miao Autonomous Prefecture 445000,Hubei Province,China;Department of Urology,Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Sciences,Xiangyang 441100,Hubei Province,China;Department of Urology,The Second People's Hospital of Yichang,Yichang 443000,Hubei Province,China;Department of Urology,The Sixth Hospital of Wuhan,Wuhan 430015,China;Department of Urology,The Third Hospital of Wuhan,Wuhan 430060,China;Department of Urology,Huaihe Hospital of Henan University,Kaifeng 475000,Henan Province,China;Department of Urology,Huanggang Central Hospital,Huanggang 438000,Hubei Province,China;Department of Urology,Qianjiang Central Hospital,Qianjiang 433100,Hubei Province,China;Department of Urology,Taihe Hospital,Affiliated Hospital of Hubei University of Medicine,Shiyan 442000,Hubei Province,China;Department of Urology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan Province,China;Department of Urology,Xiaogan First People's Hospital,Xiaogan 432000,Hubei Province,China;Department of Urology,The First People's Hospital of Jingzhou,Jingzhou 434000,Hubei Province,China;Department of

机构地区：[1]武汉大学中南医院泌尿外科,武汉430071 [2]武汉大学中南医院循证与转化医学中心,武汉430071 [3]随州市中心医院泌尿外科,湖北随州441300 [4]恩施土家族苗族自治州中心医院泌尿外科,湖北恩施445000 [5]湖北省天门市第一人民医院泌尿外科,湖北天门431700 [6]湖北民族大学附属医院泌尿外科,湖北恩施445000 [7]湖北文理学院附属医院泌尿外科,湖北襄阳441100 [8]宜昌市第二人民医院泌尿外科,湖北宜昌443000 [9]武汉市第六医院泌尿外科,武汉430015 [10]武汉市第三医院泌尿外科,武汉430060 [11]河南大学淮河医院泌尿外科,河南开封475000 [12]黄冈市中心医院泌尿外科,湖北黄冈438000 [13]潜江市中心医院泌尿外科,湖北潜江433100 [14]湖北医药学院附属太和医院泌尿外科,湖北十堰442000 [15]河南科技大学第一附属医院泌尿外科,河南洛阳471000 [16]孝感市第一人民医院泌尿外科,湖北孝感432000 [17]荆州市第一人民医院泌尿外科,湖北荆州434000 [18]华润武钢总医院泌尿外科,武汉430080 [19]开封市中心医院泌尿外科,河南开封475000 [20]北京大学第一医院泌尿外科,北京100034 [21]西安交通大学第一附属医院泌尿外科,西安710061

出　　处：《医学新知》2024年第4期381-390,共10页New Medicine

基　　金：国家重点研发计划“数字诊疗装备研发”重点专项(2016YFC0106300);湖北省技术创新专项重大项目(2016ACA152)。

摘　　要：目的探讨经尿道前列腺等离子双极电切术(transurethral plasmakinetic resection of prostate,TUPKP)治疗高危良性前列腺增生(BPH)患者的临床疗效。方法采用前瞻性多中心研究设计。在全国20家医院泌尿外科按照纳入排除标准,入组行TUPKP治疗的高危BPH患者,分析患者基线、围手术期及术后3个月随访的相关数据,评价疗效和安全性。结果2016年9月至2018年12月共入组229名高危BPH患者。与基线相比,术后3个月随访的国际前列腺症状评分改变量为-17.28[95%CI(-18.02,-16.54)]分、最大尿流率改变量为5.61[95%CI(0.68,10.54)]mL·s^(-1)、残余尿量改变量为-84.50[95%CI(-96.49,-72.51)]mL、生活质量评分改变量为-3.24[95%CI(-3.42,-3.06)]分,差异均具有统计学意义(P<0.05)。术中及术后并发症的发生率低,未发生与手术相关的不良事件。结论TUPKP可以用于治疗高危BPH患者,建议由技术熟练的术者实施手术。Objective To investigate the clinical efficacy of transurethral plasmakinetic resection of prostate(TUPKP)in treating high-risk benign prostatic hyperplasia(BPH)patients.Methods A prospective multicenter study design was employed.Patients with high-risk BPH treated with TUPKP were enrolled in the urology departments of 20 hospitals nationwide according to the inclusion and exclusion criteria.Relevant data regarding patient baseline,perioperative period,and 3-month postoperative follow-up were analyzed to evaluate efficacy and safety.Results From September 2016 to December 2018,a total of 229 high-risk BPH patients were enrolled.Compared to baseline at the 3-month followup,the change in the International Prostate Symptom Score was-17.28[95%CI(-18.02,-16.54)],the change in maximum urinary flow rate was 5.61[95%CI(0.68,10.54)]mL·s^(-1),the change in residual urine volume was-84.50[95%CI(-96.49,-72.51)]mL,and the change in quality of life score was-3.24[95%CI(-3.42,-3.06)],all showing significant differences(P<0.05).The incidence of intraoperative and postoperative complications was low,and no surgery-related adverse events occurred.Conclusion TUPKP can be used to treat high-risk BPH patients,and it is recommended to be performed by skilled surgeons.

关 键 词：经尿道前列腺等离子双极电切术 良性前列腺增生 高危患者 心血管疾病 

分 类 号：R699.8[医药卫生—泌尿科学]