三种经尿道前列腺电切术治疗前列腺增生的临床疗效比较

摘要

目的 评价经尿道前列腺等离子电切术和剜除术治疗良性前列腺增生的临床疗效和安全性.方法 选取2011年1月至2016年6月期间于我院泌尿外科确诊并符合纳入及排除标准的良性前列腺增生患者372例,根据手术方式分组,普通电切组(transurethral resection of prostate,TURP组)125例、等离子电切组(plasma kinetic resection of prostate,PKRP组)159例及等离子剜除组(plasma kinetic enucleation of prostate,PKEP组)88例,对患者术前、术中、术后的各项临床指标进行对比分析.结果 3组患者术前指标基本一致,术中及术后临床指标显示,PKRP组和PKEP组患者在出血量、术后膀胱冲洗时间、尿管留置时间、住院时间方面均优于TURP组患者,且差异具有统计学意义(P<0.05),而PKRP组和PKEP组患者之间差异不具有统计学意义(P>0.05);PKRP组和PKEP组患者的尿道电切综合征(TRUS)、术后尿失禁和尿道狭窄发生率均低于TURP组患者,且差异具有统计学意义(P<0.05),而PKRP组和PKEP组患者之间差异不具有统计学意义(P>0.05);术后6个月随访,3组在IPSS评分、QoL评分和Qmax方面均较术前好转(P<0.05),3组之间差异不具有统计学意义(P>0.05).结论 经尿道前列腺等离子电切术、经尿道前列腺等离子剜除术是治疗良性前列腺增生的理想方式,具有创伤小,安全性高、恢复快等优点,具有较大的临床推广价值.%Objective To compare the effectiveness and safety of the plasma kinetic resection of prostate and the PlasmaKinetic Enucleation of Prostate in the treatment of patients with benign prostatic hyperplasia. Methods Total of 372 patients with benign prostatic hyperplasia who have accepted different surgeries from January 2011 to Jun. 2016 were enrolled in the study. According to different operation types, they were divided into Group TURP(125 patients), Group PKRP (159 patients) and group PKEP (88 patients). Clinical indexes of three groups were comparatively analyzed. Results The three groups were consistent at baseline before operation. Clinical outcome analysis showed that group PKRP and group PKEP were superior to group TURP in the the total blood loss, the time of bladder irrigation, duration of indwelling catheter and the hospitalization time (P<0.05). There were no significant difference in clinical indexes between group PKRP and group PKEP. Occurrences of the TRUS, the uroclepsia and the urethrostenosis in group PKRP and group PKEP were lower than those in group TURP. The results of a 6-months follow-up showed that no significant difference was found inthe IPSS score, the QOL score and the Qmax among three groups (P<0.05). Conclusion The PKRP and PKEP show great advantages over TURP in safety, small wound and quick recovery for treatment of BPH. These methods are worthy to be applied widely in clinic.