前列腺动脉栓塞术与经尿道前列腺切除术治疗良性前列腺增生的前瞻性随机对照研究

摘要

目的 探讨前列腺动脉栓塞术(PAE)与经尿道前列腺切除术(TURP)治疗良性前列腺增生(BPH)的有效性及安全性.方法 选择2016年1月-10月40例BPH患者,根据数表法随机分为PAE组(20例)及TURP组(20例).对比分析2组患者术前及术后疗效评价指标[国际前列腺症状评分(IPSS)、生活质量评分(QOL)、前列腺体积(PV)、排泄后残余尿量(PVR)、最大尿流率(Qmax)、血清前列腺特异性抗原(PSA)]、术后并发症发生率及性功能障碍发生率的差异.结果 2组间术前IPSS、QOL、PV、PVR、Qmax、PSA差异均无统计学意义(P均＞0.05).术后3、6、12个月,2组患者IPSS、QOL、PV、PVR、PSA均较术前明显减低(P均＜0.05),Qmax较术前明显增高(P＜0.05);术后3个月2组间疗效指标差异均有统计学意义(P均＜0.05),术后6、12个月差异均无统计学意义(P均＞0.05).TURP组术后并发症发生率高于PAE组(x2=4.329,P=0.037).2组间性功能障碍发生率差异无统计学意义(x2=2.105,P=0.147).结论 PAE和TURP治疗BPH均可显著改善临床症状.术后3个月TURP疗效优于PAE,但PAE更微创、术后并发症少.%Objective To evaluate the efficacy and safety of prostatic arterial embolization (PAE) and transurethral resection of prostate (TURP) in treatment of benign prostatic hyperplasia (BPH).Methods Totally 40 patients with BPH from Jan 2016 to Oct 2016 were selected.All patients were divided into PAE (n=20) and TURP (n=20) group by random number table method.The curative effect indexes (international prostate symptom score [IPSS],quality of life score [QOL],prostate volume [PV],postvoid residual [PVR],maximum urinary flow rate [Qmax] and prostate-specific antigen [PSA]),the complications and side effects,as well as the incidence of sexual dysfunction were analyzed and compared between the two groups.Results No statistical difference of IPSS,QOL,PV,PVR,Qmax nor PSA was found between the two groups before operation (all P＞0.05).IPSS,QOL,PV,PVR and PSA were significantly lower than those before operation 3,6 and 12 months after operation (all P＜0.05),while Qmax was obviously higher than that before operation (P＜0.05).Three months after operation,the curative effect indexes were statistically different between the two groups (all P＜0.05),while no statistical difference was found 6 and 12 months after operation (P＞0.05).The incidence of postoperative complications in TURP group was higher than that in PAE group (x2 =4.329,P=0.037).There was no statistical difference in the incidence of sexual dysfunction between the two groups (x2=2.105,P=0.147).Conclusion PAE and TURP can significantly alleviate clinical symptoms of patients with BPH.Three months after operation,the efficacy of TURP is better than PAE,but PAE is more minimally invasive and has fewer complications.