基于倾向性匹配评分法分析铲状电极经尿道前列腺等离子剜除术与经尿道前列腺等离子电切术治疗大体积良性前列腺增生的疗效  

Analysis on the therapeutic effects of shovel-shaped electrode transurethral plasma kinetic enucleation and plasma kinetic resection of the prostate in the treatment of massive benign prostatic hyperplasia based on propensity score matching

作　　者：沙维 孙进 许凯 殷桂草 王小祥 李一帆 SHA Wei;SUN Jin;XU Kai;YIN Guicao;WANG Xiaoxiang;LI Yifan(Department of Urology,Xuyi People′s Hospital,Huai′an 211700,Jiangsu,China;Department of Urology,Yangzhou University Affiliated Hospital,Yangzhou 225000,Jiangsu,China)

机构地区：[1]盱眙县人民医院泌尿外科,江苏淮安211700 [2]扬州大学附属医院泌尿外科,江苏扬州225000

出　　处：《中国性科学》2024年第12期21-25,共5页Chinese Journal of Human Sexuality

基　　金：国家自然科学基金项目(82002675);江苏省科技计划-青年基金项目(BK2020938);江苏省中西医结合老年病防治重点实验室开放课题项目(202240);淮安市自然科学研究计划(联合专项)卫生健康类科研项目(HABL202262)。

摘　　要：目的基于倾向性匹配评分法比较分析铲状电极经尿道前列腺等离子剜除术(PKEP)与经尿道前列腺等离子电切术(PKRP)治疗大体积良性前列腺增生(>80 mL)的临床安全性和有效性。方法选取2020年1月至2022年1月扬州大学附属医院和盱眙县人民医院收治的92例大体积良性前列腺增生患者作为研究对象。根据不同治疗方式分为铲状电极PKEP组和PKRP组,每组46例。比较两组的围手术期指标,比较两组术后6个月的残余尿量(RUV)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、国际勃起功能指数-5(IIEF-5)评分,比较两组并发症发生情况。结果与PKRP组比较,铲状电极PKEP组手术时间、膀胱冲洗时间、尿管留置时间、术后住院时间更短,丢失血红蛋白更少,差异具有统计学意义(P<0.05)。术后6个月,与PKRP组比较,铲状电极PKEP组IPSS、QOL更小,Qmax更大,RUV更少,差异具有统计学意义(P<0.05);两组IIEF-5评分比较,差异无统计学意义(P>0.05)。铲状电极PKEP组膀胱痉挛、逆行射精并发症发生率低于PKRP组,差异具有统计学意义(P<0.05)。结论相较于PKRP,铲状电极PKEP治疗大体积(>80 mL)BPH患者具有改善围手术期指标、提升术后疗效、安全性更高等优势。Objective To compare and analyze the clinical safety and efficacy of shovel-shaped electrode transurethral plasma kinetic enucleation of the prostate(PKEP) and transurethral plasma kinetic resection of the prostate(PKRP) in the treatment of massive benign prostatic hyperplasia(>80 mL) based on propensity score matching. Methods A total of 346 patients with massive benign prostatic hyperplasia admitted to Yangzhou University Affiliated Hospital and Xuyi People′s Hospital from January 2020 to January 2022 were selected as the research objects. According to different treatment methods, they were divided into shovel-shaped electrode PKEP group and PKRP group, with 46 cases in each group. The perioperative indexes of the two groups were compared. The residual urine volume(RUV), international prostate symptom score(IPSS), quality of life score(QOL), maximum urine flow rate(Qmax), and international index of erectile function-5(IIEF-5) score were compared between the two groups 6 months after surgery. The incidences of complications between the two groups were compared. Results Compared with the PKRP group, the shovel-shaped electrode PKEP group had significantly shorter operative time, bladder irrigation time, indwelling catheter time and hospital stay, and less hemoglobin loss, with statistically significant differences(P<0.05). At 6 months after surgery, the shovel-shaped electrode PKEP group had smaller IPSS and QOL, larger Qmax, and less RUV compared with the PKRP group, with statistically significant differences(P<0.05). There were no significant differences in comparing the IIEF-5 score between the two groups(P<0.05). The incidences of bladder spasms and retrograde ejaculation in the shovel-shaped electrode PKEP group were lower than those in the PKRP group, with statistically significant differences(P<0.05). Conclusions Compared with PKRP, shovel-shaped electrode PKEP for massive(>80 mL) BPH patients has the advantages of improving perioperative indexes, enhancing postoperative efficacy, and higher safety, etc.

关 键 词：良性前列腺增生 经尿道前列腺等离子剜除术 经尿道前列腺等离子电切术 铲状电极 

分 类 号：R697[医药卫生—泌尿科学]