两种手术方式治疗老年良性前列腺增生患者的效果及安全性  

Comparison of the effects and voiding function in elderly patients with benign prostatic hyperplasia

作　　者：王海波[1] 章久武[1] 吴涛[1] 权良明 张成建 WANG Haibo;ZHANG Jiuwu;WU Tao;QUAN Liangming;ZHANG Chengjian(Department of Urology,Huangshan People’s Hospital,Huangshan 245000,Anhui,China)

机构地区：[1]黄山市人民医院泌尿外科,安徽黄山245000

出　　处：《西部医学》2024年第6期906-909,915,共5页Medical Journal of West China

基　　金：国家自然科学基金项目(2021YFC2009300)。

摘　　要：目的探讨传统前列腺电切术(TURP)和前列腺等离子剜除术(TUEP)治疗老年良性前列腺增生(BPH)的效果及安全性。方法选取2019年1月—2022年8月在本院接受手术治疗的老年BPH患者120例为研究对象行回顾性分析,根据手术方式分为传统前列腺电切术(TURP)组(59例)和前列腺等离子剜除术(TUEP)组(61例)。比较两组的手术时间、切除组织重量、出血量、拔管时间、术后并发症、国际前列腺症状量表(IPSS)评分、生活质量量表(QOL)评分、国际勃起功能指数量表(IIEF-5)评分、最大尿流率(Qmax)和膀胱残余尿量(PVR)。结果TUEP组手术用时、术后尿管拔除时间、冲洗膀胱的时间及在院时间均短于TURP组,出血量少于TURP组,差异有统计学意义(均P<0.05)。TUEP组的术后并发症总发生率低于TURP组,差异有统计学意义(P<0.05)。两组患者术前尿动力学参数差异无统计学意义(P>0.05)。术后3个月,两组Qmax均明显高于术前(P<0.05),但两组组间差异无统计学意义(P>0.05)。两组PVR较术前均明显下降,且TUEP组较TURP组下降明显(P<0.05)。两组IPSS、QOL评分术前差异无统计学意义(P>0.05),术后3个月较术前均明显降低,且TUEP组IPSS评分下降更明显,差异有统计学意义(P<0.05)。结论与传统TURP术相比,TUEP治疗老年BPH的临床效果确切,创伤小、恢复快,能有效恢复患者膀胱功能,明显改善患者生活质量,并发症少,值得临床推广应用。Objective To compare the effect and safety of traditional electroresection of prostate and prostate plasma enucleation of benign prostatic hyperplasia(BPH)in the elderly.Methods 120 elderly patients with BPH who received surgical treatment in our hospital from January 2019 to August 2022 were selected retrospectively as the study objects.According to the surgical methods,they were divided into the traditional prostate resection(TURP)group of 59 cases and the prostate plasma enucleation(TUEP)group of 61 cases.The operation time,weight of resected tissue,amount of bleeding,extubation time,postoperative complications,IPSS score,QOL score,IIEF-5 score,maximum urinary flow rate(Qmax)and residual urinary volume(PVR)of bladder were compared between the two treatment groups.Results The operation time,catheter indwelling time,bladder flushing time and hospitalization time of TUEP group were shorter than those of TURP group,and the amount of bleeding was less than that of TURP group,the difference was statistically significant(P<0.05).The total incidence of postoperative complications in TUEP group was lower than that in TURP group,and the difference was statistically significant(P<0.05).There was no significant difference in preoperative urodynamic parameters between the two groups(P>0.05).Three months after operation,Qmax in both groups was significantly higher than that before operation(P<0.05),and there was no significant difference between the two groups(P>0.05).PVR in the two groups decreased significantly compared with that before operation,and that in the TUEP group decreased significantly compared with that in the TURP group(P<0.05).There was no significant difference in IPSS and QOL scores between the two groups before operation(P>0.05).Three months after operation,IPSS and QOL scores in both groups were significantly lower than those before operation,and IPSS scores in TUEP group decreased more significantly,with a statistically significant difference(P<0.05).Conclusion Compared with traditional TURP,TUEP treats

关 键 词：良性前列腺增生 前列腺电切术 前列腺等离子剜除术 排尿功能 安全性 

分 类 号：R694.4[医药卫生—泌尿科学]